# BOREALIS WELLNESS CLINIC LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912279316
- **Authorized official:** DR. SAMUEL ROBERT KLINNER D.C. (OWNER)
- **Authorized official phone:** (715) 748-4433

## Contact information

- **Practice address:** 123 W STATE ST, MEDFORD, WI 54451-1772
- **Practice address phone:** (715) 748-4333
- **Practice address fax:** (715) 748-6304
- **Mailing address:** 123 W STATE ST, MEDFORD, WI 54451-1772
- **Mailing address phone:** (715) 748-4333
- **Mailing address fax:** (715) 748-6304

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 4855-12 | WI | Yes |

## Other

- **Enumeration date:** 01/31/2012
- **Last updated:** 11/02/2022