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Organization
CARDINAL CHIROPRACTIC LLC
Active
Organization
CARDINAL CHIROPRACTIC LLC
Active
Other names
Travis Malott Holdings LLC, Wilke Chiropractic Office
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS JOHN MALOTT DC (OWNER)
(608) 897-3010
Entity
Organization
Contact information
Practice address
E101 4TH ST, BRODHEAD, WI 53520-2003
(608) 897-3010
(608) 897-3011
Mailing address
E101 4TH ST, BRODHEAD, WI 53520-2003
(608) 897-3010
(608) 897-3011
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5080-12
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38941900
—
WI
01
—
534673
DEAN HEALTH PLAN
—
Enumeration date
01/16/2013
Last updated
11/08/2021
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