Pediatric, Prenatal and Family Chiropractic of Wisconsin LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

PEDIATRIC, PRENATAL AND FAMILY CHIROPRACTIC OF WISCONSIN LLC

Practice address

1524 S Green Bay Rd Ste 101
Mount Pleasant, WI 53406-5788

Phone

(262) 800-1115

NPI assigned

Jul 12, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Holly Georgeson

Title

Owner

Phone

(262) 800-1115

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686009600000",
    "number": "1164094975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 S GREEN BAY RD STE 101",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 S GREEN BAY RD STE 101",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065788",
            "telephone_number": "262-800-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC, PRENATAL AND FAMILY CHIROPRACTIC OF WISCONSIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-12",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "GEORGESON",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-800-1115"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Mount Pleasant, WI
• Providers in Mount Pleasant, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.