Organization
CARDINAL CHIROPRACTIC LLC
Active
Other names
Travis Malott Holdings LLC, Wilke Chiropractic Office
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS JOHN MALOTT DC (OWNER)
(608) 897-3010
Entity
Organization
Contact information
Practice address
E101 4TH ST, BRODHEAD, WI 53520-2003
(608) 897-3010
(608) 897-3011
Mailing address
E101 4TH ST, BRODHEAD, WI 53520-2003
(608) 897-3010
(608) 897-3011
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5080-12
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38941900
—
WI
01
—
534673
DEAN HEALTH PLAN
—
Enumeration date
01/16/2013
Last updated
11/08/2021
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