Ross Mundinger, DC
Individual provider Active NPI Chiropractor · La Crosse, WI
NPI 1447630751 · NPPES record last updated Jun 2, 2015
Key facts
- NPI
- 1447630751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 5101-12 (WI)
- Practice address
- 1022 19TH St S
La Crosse, WI 54601-5811 - Phone
- (608) 519-5690
- NPI assigned
- Jun 2, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150717000720 | WI | Practitioner - Chiropractic | 6204155930 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Breidenbach Family and Sports Chiropractic Inc | Chiropractor | Current |
Accepting new patients |
| Breidenbach Prairie View Chiropractic, LLC | Chiropractor | Past |
Accepting new patients |
| Back to Health Chiropractic LLC | Chiropractor | Past | Accepting new patients |
| Walz Physical Therapy and Wellness LLC | Past |
Accepting new patients |
Locations
1526 Rose St
Ste 102
La Crosse, WI 54603
Phone (608) 781-9880
1526 Rose St
La Crosse, WI 54603
Phone (608) 317-4644
1605 Losey Blvd S
La Crosse, WI 54601
Phone (608) 788-7880
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5101-12 | WI | Yes |
| Chiropractor | 111N00000X | 038012616 | IL |
Addresses
Primary practice location
1022 19TH St S
La Crosse, WI 54601-5811
Mailing address
1022 19TH St S
La Crosse, WI 54601-5811
Other providers in La Crosse, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.