Organization
ACTIVE HEALTH CHIROPRACTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIDGET A OWENS D.C. (OWNER)
(608) 374-3000
Entity
Organization
Contact information
Practice address
402 SUPERIOR AVE, TOMAH, WI 54660-1638
(608) 374-3000
(608) 374-3303
Mailing address
402 SUPERIOR AVE, TOMAH, WI 54660-1638
(608) 374-3000
(608) 374-3303
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2463-12
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000075689
MEDICARE PTAN
WI
Enumeration date
11/08/2011
Last updated
12/02/2011
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