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Organization

ONE SOURCE WELLNESS AND CHIROPRACTIC LLC

Active
Other names
ONE SOURCE WELLNESS AND CHIROPRACTIC
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PAUL EDWARD RALSTON DC (DC)
(262) 751-7505
Entity
Organization

Contact information

Practice address
13730 W GREENFIELD AVE, BROOKFIELD, WI 53005-7115
(262) 751-7505
Mailing address
13730 W GREENFIELD AVE, BROOKFIELD, WI 53005-7115
(262) 751-7505

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3958-12
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
111N00000X
TAXONOMY CHIROPRACTOR
WI
05
38947700
WI
Enumeration date
04/05/2016
Last updated
03/11/2020
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