| Emerson Chiropractic Wellness Center Llc | |
|
8499 State Highway 42 Fish Creek WI 54212-9419 | |
| (920) 868-9280 | |
| Not Available |
| Full Name | Emerson Chiropractic Wellness Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8499 State Highway 42, Fish Creek, Wisconsin |
| Authorized Official Name and Position | Elizabeth Anne Emerson (OWNER) |
| Authorized Official Contact | 9208689280 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerson Chiropractic Wellness Center Llc 8499 State Highway 42 Fish Creek WI 54212-9419 Ph: (920) 868-9280 | Emerson Chiropractic Wellness Center Llc 8499 State Highway 42 Fish Creek WI 54212-9419 Ph: (920) 868-9280 |
| NPI Number | 1437489416 |
|---|---|
| Provider Enumeration Date | 01/13/2010 |
| Last Update Date | 07/08/2010 |
| Medicare PECOS PAC ID | 8426189457 |
|---|---|
| Medicare Enrollment ID | O20100708000234 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437489416 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 4242-012 (Wisconsin) | Primary |
| Provider Name | Elizabeth A Emerson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1730376484 PECOS PAC ID: 6901987841 Enrollment ID: I20080116000592 |
| Provider Name | Tucker A Emerson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1730369505 PECOS PAC ID: 0244311926 Enrollment ID: I20080121000003 |