Adjust Your Life Chiropractic, LLC
Organization Active NPI Chiropractor · Cottage Grove, WI
NPI 1821367798 · NPPES record last updated Dec 22, 2011
Key facts
- NPI
- 1821367798
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 4615-12 (WI)
- Legal business name
- ADJUST YOUR LIFE CHIROPRACTIC, LLC
- Practice address
- 2850 Cottage Grove Rd
Cottage Grove, WI 53527-8862 - Phone
- (608) 839-3513
- Fax
- (608) 839-3533
- NPI assigned
- Dec 22, 2011
- Organization subpart
- No
Authorized official
- Name
- Caroline Ruppert, D.C.
- Title
- Member
- Phone
- (608) 839-3513
Practitioners 1
-
Caroline Jean Ruppert, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120423000719 | WI | Part B Supplier - Clinic/Group Practice | 2264694058 |
Receives reassigned benefits from 1 practitioner Practice locations: Cottage Grove, WI |
National Provider Directory
Locations
600 Fundamental Way
Unit A
Cottage Grove, WI 53527
Phone (608) 509-2884
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 4615-12 | WI | Yes |
Addresses
Primary practice location
2850 Cottage Grove Rd
Cottage Grove, WI 53527-8862
Mailing address
2850 Cottage Grove Rd
Cottage Grove, WI 53527-8862
Phone (608) 839-3513
Other providers in Cottage Grove, WI
- Seth Erik Anderson
- Suzanne M Anderson
- Applewhite Dental Wisconsin, P.C.
- Allison Rohease Attoe
- Kimberly M Belmarez
All providers in Cottage Grove, WI · Chiropractor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2011. 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.