| Active Family Chiropractic Center Llc | |
|
610 South St Green Lake WI 54941-9496 | |
| (920) 229-7215 | |
| Not Available |
| Full Name | Active Family Chiropractic Center Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 610 South St, Green Lake, Wisconsin |
| Authorized Official Name and Position | Andrea M King (OWNER) |
| Authorized Official Contact | 9202297215 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Active Family Chiropractic Center Llc Po Box 163 Green Lake WI 54941-0163 Ph: (920) 229-7215 | Active Family Chiropractic Center Llc 610 South St Green Lake WI 54941-9496 Ph: (920) 229-7215 |
| NPI Number | 1992945182 |
|---|---|
| Provider Enumeration Date | 02/27/2009 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992945182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Wisconsin) | Primary |
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