Active NPI
At-Home Auto Accident Treatment, LLC
- Chiropractor
- West Allis, WI
National Provider Identifier
1053756700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3364
- Legal business name
- AT-HOME AUTO ACCIDENT TREATMENT, LLC
- Practice address
- 5800 W National Ave
West Allis, WI 53214-3446 - Phone
- (262) 682-1101
- NPI assigned
- May 8, 2013
- Last updated
- May 8, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Brian Formolo, D.C.
- Title
- Owner
- Phone
- (262) 682-1101
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3364 | WI | Primary |
Addresses
Primary practice location
5800 W National Ave
West Allis, WI 53214-3446
Mailing address
PO Box 11
Muskego, WI 53150-0011
National Provider Directory
National Provider Directory- Tax ID family
- At-Home Auto Accident Treatment LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Chiropractor
- West Allis, WI
- NPI 1235398272
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Chiropractor
- Oak Creek, WI
- NPI 1760427207
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367971200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1367971200000",
"number": "1053756700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11",
"city": "MUSKEGO",
"state": "WI",
"postal_code": "531500011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5800 W NATIONAL AVE",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532143446",
"telephone_number": "262-682-1101"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AT-HOME AUTO ACCIDENT TREATMENT, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-05-08",
"last_updated": "2013-05-08",
"status": "A",
"authorized_official_last_name": "FORMOLO",
"authorized_official_first_name": "BRIAN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "262-682-1101",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "3364",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Allis, WI
- Carmen Marie Arteaga, SAC-IT
- Asap-Behavioral Health, SC
- John Frank Ash, P.T.
- Assessment and Therapeutic Solutions, LLC
- Associated Obstetricians and Gynecologists, LTD
- Athletic & Therapeutic Institute of Milwaukee, LLC (ATI Physical Therapy)
- Atlas Healthcare, Inc
- Attentive Care Inc
- Brittani Atwood, M.S., CFY-SLP
- Aurora Advanced Healthcare, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.