Organization
RADIANT NATURAL HEALTH CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KERRY NIEBRZYDOWSKI ND LAC (OWNER)
(715) 251-3555
Entity
Organization
Contact information
Practice address
619 WASHINGTON AVE, NIAGARA, WI 54151
(715) 251-3555
(715) 251-3559
Mailing address
PO BOX 243, NIAGARA, WI 54151
(715) 251-3555
(715) 251-3559
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
652-55
WI
171100000X
Acupuncturist
857-55
WI
Other
Enumeration date
09/05/2017
Last updated
09/05/2017
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