Organization
MARK J. PENSIS CHIROPRACTIC, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNON HELEN TREMPER (OFFICE MANAGER)
(715) 823-2912
Entity
Organization
Contact information
Practice address
275 S MAIN ST, CLINTONVILLE, WI 54929-1604
(715) 823-2912
Mailing address
PO BOX 266, CLINTONVILLE, WI 54929-0266
(715) 823-2912
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2292-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38833800
—
WI
01
—
391524586016
BLUE CROSS
WI
01
—
6264
NETWORK
WI
Enumeration date
12/04/2006
Last updated
08/22/2020
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