Russell Chiropractic Llc | |
425 Bridge St, Cornell, WI 54732-8391 | |
(715) 239-0909 | |
(715) 239-0908 |
Full Name | Russell Chiropractic Llc |
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Type | Facility |
Speciality | Chiropractor |
Location | 425 Bridge St, Cornell, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1548567662 | NPI | - | NPPES |
38183500 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 4384012 (Wisconsin) | Primary |
Provider Name | Jacquelyn M Russell |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1669560413 PECOS PAC ID: 2365512787 Enrollment ID: I20080528000286 |
Provider Name | Keith A Levick |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1891986501 PECOS PAC ID: 3375616238 Enrollment ID: I20080725000082 |
Mailing Address | Practice Location Address |
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Russell Chiropractic Llc 425 Bridge St, Cornell, WI 54732-8391 Ph: (715) 239-0909 | Russell Chiropractic Llc 425 Bridge St, Cornell, WI 54732-8391 Ph: (715) 239-0909 |
Cornell Chiropractic, Llc Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 425 Bridge St, Cornell, WI 54732 Phone: 715-239-0909 | |
Dr. Jacquelyn Michele Russell, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 425 Bridge St, Cornell, WI 54732 Phone: 715-239-0909 Fax: 715-239-0908 |