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Organization
ZASTROW CHIROPRACTIC OFFICE, LLC
Active
Organization
ZASTROW CHIROPRACTIC OFFICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL LAWRENCE ZASTROW D.C. (OWNER)
(920) 465-0400
Entity
Organization
Contact information
Practice address
1624 E MASON ST, GREEN BAY, WI 54302-2739
(920) 465-0400
(920) 465-1430
Mailing address
1624 E MASON ST, GREEN BAY, WI 54302-2739
(920) 465-0400
(920) 465-1430
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
1813-12
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38777600
—
WI
Enumeration date
08/25/2014
Last updated
08/25/2014
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