Provider Demographics
NPI:1114452091
Name:NORTH POINT CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:NORTH POINT CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:SANDSTROM
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:414-482-5282
Mailing Address - Street 1:21150 W CAPITOL DR STE 5
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53072-2913
Mailing Address - Country:US
Mailing Address - Phone:414-482-5282
Mailing Address - Fax:414-877-1409
Practice Address - Street 1:21150 CAPITOL DR
Practice Address - Street 2:SUITE 5
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53072-2911
Practice Address - Country:US
Practice Address - Phone:414-482-5282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-27
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5272-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty