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Organization
ALIGNED MODERN WELLNESS LLC
Active
Organization
ALIGNED MODERN WELLNESS LLC
Active
Other names
Rademaker Family Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TREVA RADEMAKER DC (OWNER)
(414) 235-8740
Entity
Organization
Contact information
Practice address
6278 S 108TH ST, HALES CORNERS, WI 53130-2527
(414) 235-8740
(414) 435-3129
Mailing address
6278 S 108TH ST, HALES CORNERS, WI 53130-2527
(414) 235-8740
(414) 435-3129
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3746-12
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016310003
PTAN
WI
05
—
38938300
—
WI
Enumeration date
12/05/2013
Last updated
01/29/2015
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