Chiropractic Firsts.C.
Organization Active NPI Chiropractor · Mukwonago, WI
NPI 1720280829 · NPPES record last updated Jul 10, 2015
Key facts
- NPI
- 1720280829
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 3709-012 (WI)
- Legal business name
- CHIROPRACTIC FIRSTS.C.
- Practice address
- 603 N Rochester St
Mukwonago, WI 53149-1139 - Phone
- (262) 363-5021
- Fax
- (262) 363-5037
- NPI assigned
- Jun 1, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Mark Davis, D.C.
- Title
- Owner Doctor
- Phone
- (262) 363-5021
Practitioners 3
-
Chad Andrew Rechcygl, D.C.
-
Linsay Jaymie Way, D.C.
-
James S Krueger, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050222000283 | WI | Part B Supplier - Clinic/Group Practice | 8628021466 |
Receives reassigned benefits from 1 practitioner Practice locations: Mukwonago, WI |
National Provider Directory
Locations
121 Wolf Run
Ste 1
Mukwonago, WI 53149
Phone (262) 363-5021
603 N Rochester St
Mukwonago, WI 53149
Phone (262) 363-4041
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 3709-012 | WI | Yes |
Addresses
Primary practice location
603 N Rochester St
Mukwonago, WI 53149-1139
Mailing address
603 N Rochester St
Mukwonago, WI 53149-1139
Phone (262) 363-5021
Other providers in Mukwonago, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 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.