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Organization
BOREALIS WELLNESS CLINIC LLC
Active
Organization
BOREALIS WELLNESS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL ROBERT KLINNER D.C. (OWNER)
(715) 748-4433
Entity
Organization
Contact information
Practice address
123 W STATE ST, MEDFORD, WI 54451-1772
(715) 748-4333
(715) 748-6304
Mailing address
123 W STATE ST, MEDFORD, WI 54451-1772
(715) 748-4333
(715) 748-6304
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
4855-12
WI
Other
Enumeration date
01/31/2012
Last updated
11/02/2022
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