Shauna Rae Mundinger
Individual provider Active NPI Chiropractor · La Crosse, WI
NPI 1578956454 · NPPES record last updated Jun 2, 2015
Key facts
- NPI
- 1578956454
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 5028-12 (WI)
- Practice address
- 1022 19TH St S
La Crosse, WI 54601-5811 - Phone
- (858) 997-9320
- NPI assigned
- Mar 16, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5028-12 | WI | Yes |
Addresses
Primary practice location
1022 19TH St S
La Crosse, WI 54601-5811
Mailing address
1022 19TH St S
La Crosse, WI 54601-5811
Phone (858) 997-9320
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.