Pewaukee Family Chiropractic Sc | |
N28w23000 Roundy Dr Ste 101, Pewaukee, WI 53072-7300 | |
(262) 695-9206 | |
Not Available |
Full Name | Pewaukee Family Chiropractic Sc |
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Type | Facility |
Speciality | Chiropractor |
Location | N28w23000 Roundy Dr Ste 101, Pewaukee, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1356492284 | NPI | - | NPPES |
38955000 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 3904-012 (Wisconsin) | Primary |
Provider Name | Bradley Christopher Pearce |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1346391265 PECOS PAC ID: 0143295212 Enrollment ID: I20040909000711 |
Provider Name | Mandy Marie Pearce |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1487661138 PECOS PAC ID: 3476568700 Enrollment ID: I20060208000228 |
Mailing Address | Practice Location Address |
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Pewaukee Family Chiropractic Sc N28w23000 Roundy Dr Ste 101, Pewaukee, WI 53072-7300 Ph: (262) 695-9206 | Pewaukee Family Chiropractic Sc N28w23000 Roundy Dr Ste 101, Pewaukee, WI 53072-7300 Ph: (262) 695-9206 |
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