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Organization
DR THOMAS J SOLECKI JR SC
Active
Organization
DR THOMAS J SOLECKI JR SC
Active
Other names
Sports & Family Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE ELIZABETH COUNTERMAN (BUSINESS MANAGER)
(262) 925-9000
Entity
Organization
Contact information
Practice address
6123 GREEN BAY RD, SUITE 140, KENOSHA, WI 53142-2927
(262) 653-9208
(262) 653-9264
Mailing address
PO BOX 158, KENOSHA, WI 53141-0158
(262) 925-9000
(262) 925-8997
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038009230
IL
111N00000X
Chiropractor
Primary
3590
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38910800
—
WI
01
—
398964451007
BCBS OF WI
—
Enumeration date
09/19/2005
Last updated
09/18/2008
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