Provider Demographics
NPI:1255688487
Name:LEO O POWERS DBA POWERS CHIROPRACTIC
Entity Type:Organization
Organization Name:LEO O POWERS DBA POWERS CHIROPRACTIC
Other - Org Name:POWERS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEO
Authorized Official - Middle Name:O
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-341-7102
Mailing Address - Street 1:PO BOX 872
Mailing Address - Street 2:
Mailing Address - City:PLOVER
Mailing Address - State:WI
Mailing Address - Zip Code:54467-0872
Mailing Address - Country:US
Mailing Address - Phone:715-341-7102
Mailing Address - Fax:
Practice Address - Street 1:2585 POST RD
Practice Address - Street 2:
Practice Address - City:PLOVER
Practice Address - State:WI
Practice Address - Zip Code:54467-3334
Practice Address - Country:US
Practice Address - Phone:715-341-7102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies