Cherryland Chiropractic and Rehabilitation, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5045-12 Issued in WI

Legal business name

CHERRYLAND CHIROPRACTIC AND REHABILITATION, LLC

Practice address

810 S Lansing Ave Ste a
Sturgeon Bay, WI 54235-2858

Phone

(920) 743-1000

NPI assigned

Feb 3, 2015

Last updated

Feb 3, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Derek Grenfell, D.C.

Title

Owner

Phone

(920) 743-1000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1422921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422921600000",
    "number": "1740670348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 S LANSING AVE STE A",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542352858",
            "telephone_number": "920-743-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 S LANSING AVE STE A",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542352858",
            "telephone_number": "920-743-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERRYLAND CHIROPRACTIC AND REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-03",
        "last_updated": "2015-02-03",
        "status": "A",
        "authorized_official_last_name": "GRENFELL",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-743-1000",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5045-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Sturgeon Bay, WI
• Providers in Sturgeon Bay, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.