Provider Demographics
NPI:1336292499
Name:ART OF WELLNESS CHIROPRACTIC SC
Entity Type:Organization
Organization Name:ART OF WELLNESS CHIROPRACTIC SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BESS
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROMAGNA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:414-365-3003
Mailing Address - Street 1:5600 W BROWN DEER RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:BROWN DEER
Mailing Address - State:WI
Mailing Address - Zip Code:53223-2346
Mailing Address - Country:US
Mailing Address - Phone:414-365-3003
Mailing Address - Fax:414-221-0288
Practice Address - Street 1:5600 W BROWN DEER RD
Practice Address - Street 2:SUITE 208
Practice Address - City:BROWN DEER
Practice Address - State:WI
Practice Address - Zip Code:53223-2346
Practice Address - Country:US
Practice Address - Phone:414-365-3003
Practice Address - Fax:414-221-0288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4255-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI389-70900Medicaid