Organization
BOSMA CHIROPRACTIC L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY RICHARD BOSMA D.C. (OWNER)
(920) 532-6450
Entity
Organization
Contact information
Practice address
450 HIGH ST., STE 4, WRIGHTSTOWN, WI 54180
(920) 532-6450
(920) 532-6455
Mailing address
450 HIGH ST., STE 4, WRIGHTSTOWN, WI 54180
(920) 532-6450
(920) 532-6455
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3807-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
389-36600
—
WI
Enumeration date
04/23/2007
Last updated
08/22/2020
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