Spring Into Life Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4097 Issued in WI

Legal business name

SPRING INTO LIFE CHIROPRACTIC, LLC

Practice address

903 S 17TH Ave
Suite D
Wausau, WI 54401-5700

Phone

(715) 845-6800

NPI assigned

Apr 23, 2010

Organization subpart

No

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

Authorized official

Name

Travis Diederich, D.C.

Title

Owner

Phone

(715) 845-6800

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271980800000",
    "number": "1285951707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 S 17TH AVE",
            "address_2": "SUITE D",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544015700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 S 17TH AVE",
            "address_2": "SUITE D",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544015700",
            "telephone_number": "715-845-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING INTO LIFE CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A",
        "authorized_official_last_name": "DIEDERICH",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-845-6800",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Calvin D. Sprik, M.D.
• Tracy Denise Springer, SAC
• Ashley E St Clair, NP
• Maunee St. Germaine, PTA
• Susan Stacker
• Samuel Staehling

• Chiropractor in Wausau, WI
• Providers in Wausau, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.