Organization
ELITE SPORT & SPINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ZACH SHIELS D.C. (OWNER)
(920) 723-5197
Entity
Organization
Contact information
Practice address
1375 S CHEROKEE DR, WAUKESHA, WI 53186-5343
(920) 723-5197
Mailing address
1375 S CHEROKEE DR, WAUKESHA, WI 53186-5343
(920) 723-5197
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4968-12
WI
Other
Enumeration date
11/02/2013
Last updated
11/02/2013
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