Organization
BACK TO BASICS COMMUNITY CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY CONN FLETCHER DC (PRESIDENT)
(920) 420-5751
Entity
Organization
Contact information
Practice address
181 E NORTH WATER ST, SUITE 115, NEENAH, WI 54956-2722
(920) 637-1084
Mailing address
181 E NORTH WATER ST, SUITE 115, NEENAH, WI 54956-2722
(920) 637-1084
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
472012
WI
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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