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Organization
ADVANCED CHIROPRACTIC OF GREEN BAY LLC
Active
Organization
ADVANCED CHIROPRACTIC OF GREEN BAY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN J PURSEL DC (MANAGING MEMBER/OWNER)
(920) 434-7393
Entity
Organization
Contact information
Practice address
2149 VELP AVE, SUITE 300, GREEN BAY, WI 54303-5424
(920) 434-7393
(920) 434-7394
Mailing address
2149 VELP AVE, SUITE 300, GREEN BAY, WI 54303-5424
(920) 434-7393
(920) 434-7394
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3102
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
388-78-200
—
WI
Enumeration date
02/23/2012
Last updated
02/23/2012
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