Organization
PREMIER CHIROPRACTIC & WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE M. JACQUETTE D.C. (MEMBER)
(414) 930-2363
Entity
Organization
Contact information
Practice address
17040 W GREENFIELD AVE STE 3, BROOKFIELD, WI 53005-6899
(414) 930-2363
Mailing address
17040 W GREENFIELD AVE STE 3, BROOKFIELD, WI 53005-6899
(414) 930-2363
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2640
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38851400
—
WI
Enumeration date
11/25/2017
Last updated
06/16/2018
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