Scott J. Wagenknecht, Llc | |
8405 W Forest Home Ave Ste 101, Greenfield, WI 53228-3407 | |
(414) 423-9225 | |
(414) 421-7516 |
Full Name | Scott J. Wagenknecht, Llc |
---|---|
Type | Facility |
Speciality | Chiropractor |
Location | 8405 W Forest Home Ave Ste 101, Greenfield, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568644060 | NPI | - | NPPES |
38925100 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 3592-012 (Wisconsin) | Primary |
Provider Name | Scott J Wagenknecht |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1952393910 PECOS PAC ID: 1557263076 Enrollment ID: I20040124000239 |
Mailing Address | Practice Location Address |
---|---|
Scott J. Wagenknecht, Llc 8405 W Forest Home Ave Ste 101, Greenfield, WI 53228-3407 Ph: (414) 423-9225 | Scott J. Wagenknecht, Llc 8405 W Forest Home Ave Ste 101, Greenfield, WI 53228-3407 Ph: (414) 423-9225 |
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