Healthsource Chiropractic & Progressive Wellness
LBN: Lake Delton Chiropractic Clinic Llc
Healthsource Chiropractic & Progressive Wellness is an health care organization with primary practice located at 151 Wisconsin Dells Pkwy S , Wisconsin Dells WI 53965. The organization recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as the primary health care specialty.
Lake Delton Chiropractic Clinic Llc can be contacted via phone (608) 253-0102, or through Bauer, Todd Joseph via phone (608) 697-9994.
Contact Information
Primary practice address
151 Wisconsin Dells Pkwy S
Wisconsin Dells WI 53965
Phone: (608) 253-0102
Fax: (608) 253-0188
Website:
Authorized official contact:
Name: Bauer, Todd Joseph Doctor of Chiropractic (DC)
Phone: (608) 697-9994
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 4029-012 | Wisconsin |
Profile Details
| NPI number | 1619087871 |
|---|---|
| LBN Legal business name | Lake Delton Chiropractic Clinic Llc |
| DBA Doing business as | Healthsource Chiropractic & Progressive Wellness |
| Authorized official | Bauer, Todd Joseph Doctor of Chiropractic (DC) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | May 17th, 2019 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619087871 | NPPES |
| Wisconsin | MEDICAID | 39000300 |
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