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Organization
WEST SIDE CHIROPRACTIC CLINIC SC
Active
Organization
WEST SIDE CHIROPRACTIC CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JAMES ROCKSTROH DC (PRESIDENT OWNER)
(920) 494-1613
Entity
Organization
Contact information
Practice address
2311 W MASON ST, GREEN BAY, WI 54303-4708
(920) 494-1613
Mailing address
2311 W MASON ST, GREEN BAY, WI 54303-4708
(920) 494-1613
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2319 012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38835500
—
WI
Enumeration date
12/20/2006
Last updated
03/16/2012
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