Valley Spine and Sport, LLC

Organization Active NPI Clinic/Center · Park Falls, WI

NPI 1104184613 · NPPES record last updated May 3, 2012

Key facts

NPI
1104184613
Entity type
Organization (NPI type 2)
Primary specialty
Clinic/Center 261Q00000X
License
4837-12 (WI)
Legal business name
VALLEY SPINE AND SPORT, LLC
Practice address
N14889 Kaiser Rd
Park Falls, WI 54552-8221
Phone
(608) 780-4937
NPI assigned
May 3, 2012
Organization subpart
No

Authorized official

Name
Dr. Alex John Tapplin, D.C.
Title
Chiropractor
Phone
(608) 780-4937

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20121016000021 WI Part B Supplier - Clinic/Group Practice 1052561792 Receives reassigned benefits from 3 practitioners
Practice locations: Appleton, WI

National Provider Directory

Locations

1901 E Capitol Dr
#A
Appleton, WI 54911
Phone (920) 585-6849

3420 N Association Dr
#A
Appleton, WI 54914
Phone (920) 931-2532

145 W Wisconsin Ave
Ste G
Neenah, WI 54956
Phone (920) 931-2532

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 4837-12 WI Yes

Addresses

Primary practice location

N14889 Kaiser Rd
Park Falls, WI 54552-8221

Mailing address

N14889 Kaiser Rd
Park Falls, WI 54552-8221

Other providers in Park Falls, WI

All providers in Park Falls, WI · Clinic/Center in Wisconsin

Sources for this page

Verify at the official NPI Registry.