Organization
BOLES CHIROPRACTIC CENTRE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELENA C BOLES D.C. (OWNER)
(414) 476-0111
Entity
Organization
Contact information
Practice address
12201 W NORTH AVENUE, STE 204, WAUWATOSA, WI 53226-2061
(414) 476-0111
(414) 476-0832
Mailing address
12201 W NORTH AVE, STE 204, WAUWATOSA, WI 53226-2061
(414) 476-0111
(414) 476-0832
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3248
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952460396
INDIVIDUAL NPI
—
Enumeration date
05/27/2010
Last updated
06/02/2010
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