ONE SOURCE WELLNESS AND CHIROPRACTIC LLC NPI 1710341847

NPI Information

NPI: 1710341847
Provider Name: ONE SOURCE WELLNESS AND CHIROPRACTIC LLC

Doing Business As: ONE SOURCE WELLNESS AND CHIROPRACTIC

Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
13730 W GREENFIELD AVE
BROOKFIELD, WI
ZIP 53005
Phone: (262) 751-7505
Get Directions

ONE SOURCE WELLNESS AND CHIROPRACTIC LLC is a chiropractor in Brookfield, 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. ONE SOURCE WELLNESS AND CHIROPRACTIC LLC NPI is 1710341847. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As One Source Wellness And Chiropractic.

The provider's business location address is:

13730 W GREENFIELD AVE
BROOKFIELD, WI
ZIP 53005-115
Phone: (262) 751-7505

The provider's authorized official is Paul Edward Ralston .
The authorized official title is Dc and has the following contact phone number (262) 751-7505.

The enumeration date for this NPI number is 4/5/2016 and was last updated on 3/11/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111N00000X	Chiropractor		3958-12	WISCONSIN	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	111N00000X	OTHER	WISCONSIN	TAXONOMY CHIROPRACTOR
2	38947700	MEDICAID	WISCONSIN

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

NPI Synchronization or Removal

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