Miranda Abbott
Individual provider Active NPI Chiropractor · Appleton, WI
NPI 1932487931 · NPPES record last updated Jul 26, 2011
Key facts
- NPI
- 1932487931
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 4759-012 (WI)
- Practice address
- 2561 E Calumet St
Appleton, WI 54915-4748 - Phone
- (920) 243-7140
- Fax
- (877) 346-6682
- NPI assigned
- Jul 26, 2011
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4759-012 | WI | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4759-012 | WI | Yes |
Addresses
Primary practice location
2561 E Calumet St
Appleton, WI 54915-4748
Mailing address
2561 E Calumet St
Appleton, WI 54915-4748
Phone (920) 243-7140
Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2011. 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.