Organization
ASCEND HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN J QUERLO DC (CLINIC DIRECTOR)
(920) 884-1989
Entity
Organization
Contact information
Practice address
550 N. MILITARY AVE, SUITE 13, GREEN BAY, WI 54303
(920) 884-1989
(920) 884-8120
Mailing address
550 N. MILITARY AVE, SUITE 13, GREEN BAY, WI 54303
(920) 884-1989
(920) 884-8120
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2948-012
WI
146N00000X
Basic Emergency Medical Technician
1064023
WI
146N00000X
Basic Emergency Medical Technician
30743-020
WI
363AM0700X
Medical Physician Assistant
S81585
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093715351
NPI
WI
01
—
1174685598
NPI
WI
01
—
1245230564
NPI
WI
Enumeration date
03/29/2007
Last updated
03/06/2009
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