NPIMap

Organization Active NPI

Chiropractic Neurology Center of Green Bay, LLC

  • Neurology Chiropractor
  • Green Bay, WI
National Provider Identifier
1295004992
Registry record updated Dec 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
3434 Issued in WI
Legal business name
CHIROPRACTIC NEUROLOGY CENTER OF GREEN BAY, LLC
Practice address
2625 Development Dr
Suite 10
Green Bay, WI 54311-4250
Phone
(920) 339-9581
Fax
(920) 339-9340
NPI assigned
Dec 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2011

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

Authorized official

Name
Dr. Scott Harold Wruck, D.C.NPI 1932317096
Title
Owner
Phone
(920) 339-9581

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)CodeLicenseStatePrimary
Neurology ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NN0400X 3434 WI Primary

Addresses

Primary practice location

2625 Development Dr
Suite 10
Green Bay, WI 54311-4250

Mailing address

2625 Development Dr
Suite 10
Green Bay, WI 54311-4250
Phone (920) 339-9581

National Provider Directory

National Provider Directory

Locations

2625 Development Dr
Ste 10
Green Bay, WI 54311
Phone (920) 339-9581

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1324857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324857600000",
    "number": "1295004992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 DEVELOPMENT DR",
            "address_2": "SUITE 10",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114250",
            "telephone_number": "920-339-9581",
            "fax_number": "920-339-9340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 DEVELOPMENT DR",
            "address_2": "SUITE 10",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114250",
            "telephone_number": "920-339-9581",
            "fax_number": "920-339-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC NEUROLOGY CENTER OF GREEN BAY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-26",
        "last_updated": "2011-12-26",
        "status": "A",
        "authorized_official_last_name": "WRUCK",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "HAROLD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-339-9581",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Neurology",
            "state": "WI",
            "license": "3434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2011; 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.