Balanced Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5116-12 Issued in WI

Legal business name

BALANCED CHIROPRACTIC LLC

Practice address

6729 Lake Rd
Windsor, WI 53598-9701

Phone

(812) 212-2043

NPI assigned

Oct 4, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Jeremy Allen Quick, D.C.

Title

Owner/Chiropractor

Phone

(608) 842-2622

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Balanced Chiropractic LLC Other name

Locations

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635984000000",
    "number": "1710437652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6729 LAKE RD STE 3",
            "city": "WINDSOR",
            "state": "WI",
            "postal_code": "535989701",
            "telephone_number": "608-842-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6729 LAKE RD",
            "city": "WINDSOR",
            "state": "WI",
            "postal_code": "535989701",
            "telephone_number": "812-212-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-04",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A",
        "authorized_official_last_name": "QUICK",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "608-842-2622",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5116-12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1710437652",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Balanced Chiropractic LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Balanced Chiropractic LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; 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.