| West Side Chiropractic Clinic Sc | |
|
2311 W Mason St, Green Bay, WI 54303-4708 | |
| (920) 494-1613 | |
| Not Available |
| Full Name | West Side Chiropractic Clinic Sc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 2311 W Mason St, Green Bay, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780748459 | NPI | - | NPPES |
| 38835500 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 2319 012 (Wisconsin) | Primary |
| Provider Name | Michael James Rockstroh |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1053472977 PECOS PAC ID: 1759530314 Enrollment ID: I20120926000218 |
| Mailing Address | Practice Location Address |
|---|---|
| West Side Chiropractic Clinic Sc 2311 W Mason St, Green Bay, WI 54303-4708 Ph: (920) 494-1613 | West Side Chiropractic Clinic Sc 2311 W Mason St, Green Bay, WI 54303-4708 Ph: (920) 494-1613 |
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