Organization · Type 2 NPI
Healthsource of Bangor S C
Chiropractor · Bangor, WI
NPI number
1912167057
Active
Practice location
1505 Commercial St
Bangor, WI 54614-0410
Fax (608) 486-4661
Mailing address
PO Box 410
Bangor, WI 54614-0410
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor Primary | 111N00000X | 2555 (WI) |
Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
Another provider at this address
About NPI 1912167057
Healthsource of Bangor S C's National Provider Identifier is 1912167057, issued on Jun 12, 2008. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Bangor, WI. The record was last updated on Jun 12, 2008.