Provider Type Icon

PROCARE CHIROPRACTIC CLINIC LTD NPI 1023229903


NPI Information

NPI: 1023229903
Provider Name: PROCARE CHIROPRACTIC CLINIC LTD
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
940 HANSEN RD
STE F
GREEN BAY, WI
ZIP 54304
Phone: (920) 496-6000
Get Directions

PROCARE CHIROPRACTIC CLINIC LTD is a chiropractor in Green Bay, WI. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. PROCARE CHIROPRACTIC CLINIC LTD NPI is 1023229903. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

940 HANSEN RD
STE F
GREEN BAY, WI
ZIP 54304-377
Phone: (920) 496-6000
Fax: (920) 496-0998

The provider's authorized official is Ray Roddan .
The authorized official title is President and has the following contact phone number (920) 496-6000.

The enumeration date for this NPI number is 5/24/2007 and was last updated on 3/5/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractor1451WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13980300MEDICAIDWISCONSIN
2000075562MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.