Summit Spine and Sport LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5074 Issued in WI

Legal business name

SUMMIT SPINE AND SPORT LLC

Practice address

616 S Farwell St
Eau Claire, WI 54701-3828

Phone

(715) 563-2201

NPI assigned

May 21, 2015

Organization subpart

No

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

Authorized official

Name

Elizabeth Gallick, DC

Title

Owner

Phone

(715) 563-2201

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432166400000",
    "number": "1376922401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 GERMANIA ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547033147",
            "telephone_number": "715-563-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 S FARWELL ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547013828",
            "telephone_number": "715-563-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT SPINE AND SPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-21",
        "last_updated": "2015-05-21",
        "status": "A",
        "authorized_official_last_name": "GALLICK",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-563-2201",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; 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.