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Organization
NORTHERN CHIROPRACTIC AND WELLNESS LLC
Active
Organization
NORTHERN CHIROPRACTIC AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLEN J. BLANCK-GROTT D.C. (OWNER/DOCTOR OF CHIROPRACTIC)
(715) 854-5025
Entity
Organization
Contact information
Practice address
709 DYER ST, CRIVITZ, WI 54114-7480
(715) 854-5025
Mailing address
PO BOX 593, CRIVITZ, WI 54114-0593
(715) 854-5025
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5160-12
WI
Other
Enumeration date
10/13/2016
Last updated
10/13/2016
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