Provider Demographics
NPI:1235278771
Name:UNWIN CHIROPRACTIC & WELLNESS CENTER, S.C.
Entity Type:Organization
Organization Name:UNWIN CHIROPRACTIC & WELLNESS CENTER, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:G
Authorized Official - Last Name:UNWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:608-848-1800
Mailing Address - Street 1:212 E VERONA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-1223
Mailing Address - Country:US
Mailing Address - Phone:608-848-1800
Mailing Address - Fax:608-848-1802
Practice Address - Street 1:212 E VERONA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-1223
Practice Address - Country:US
Practice Address - Phone:608-848-1800
Practice Address - Fax:608-848-1802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000035838Medicare ID - Type Unspecified