Organization
ACTIVE CHIROPRACTIC CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A CASSELLIUS D.C. (OWNER)
(608) 783-3307
Entity
Organization
Contact information
Practice address
419 SAND LAKE RD, ONALASKA, WI 54650-2706
(608) 783-3307
(608) 779-9728
Mailing address
419 SAND LAKE RD, ONALASKA, WI 54650-2706
(608) 783-3307
(608) 779-9728
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2239
WI
Other
Enumeration date
08/19/2010
Last updated
04/26/2011
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