Organization
WEST SIDE CHIROPRACTIC CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JAMES ROCKSTROH DC (PRESIDENT OWNER)
(920) 494-1613
Entity
Organization
Contact information
Practice address
2311 W MASON ST, GREEN BAY, WI 54303-4708
(920) 494-1613
Mailing address
2311 W MASON ST, GREEN BAY, WI 54303-4708
(920) 494-1613
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2319 012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38835500
—
WI
Enumeration date
12/20/2006
Last updated
03/16/2012
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