Provider Demographics
NPI:1043878044
Name:NECK & BACK PAIN RELIEF CHIROPRACTIC CENTER, LLC
Entity Type:Organization
Organization Name:NECK & BACK PAIN RELIEF CHIROPRACTIC CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:MUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:414-333-9256
Mailing Address - Street 1:9309 S SPRINGHILL LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-9141
Mailing Address - Country:US
Mailing Address - Phone:414-333-9256
Mailing Address - Fax:
Practice Address - Street 1:8233 S 27TH ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-9310
Practice Address - Country:US
Practice Address - Phone:414-333-9256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty