Waunakee Chiropractic, LLC
Organization Active NPI Chiropractor · Waunakee, WI
NPI 1043353329 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1043353329
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2647-012 (WI)
- Legal business name
- WAUNAKEE CHIROPRACTIC, LLC
- Practice address
- 1024 Quinn Dr
Waunakee, WI 53597-2501 - Phone
- (608) 849-4521
- Fax
- (608) 849-8516
- NPI assigned
- Feb 15, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Paula Lee, DC
- Title
- Member
- Phone
- (608) 849-4521
Practitioners 2
-
Paula Lee, DC
-
Jill M Mikkelson, DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051121000028 | WI | Part B Supplier - Clinic/Group Practice | 8729007638 |
Receives reassigned benefits from 1 practitioner Practice locations: Waunakee, WI |
National Provider Directory
Locations
806 S Division St
Ste D
Waunakee, WI 53597
Phone (608) 849-4521
1024 Quinn Dr
Waunakee, WI 53597
Phone (608) 848-4521
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 2647-012 | WI | Yes |
Addresses
Primary practice location
1024 Quinn Dr
Waunakee, WI 53597-2501
Mailing address
1024 Quinn Dr
Waunakee, WI 53597-2501
Phone (608) 849-4521
Other providers in Waunakee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.