Provider Demographics
NPI:1417135138
Name:MICHALSKI CHIROPRACTIC WELLNESS CENTRE, S.C.
Entity Type:Organization
Organization Name:MICHALSKI CHIROPRACTIC WELLNESS CENTRE, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC ORTHOPEDIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:THADEUS
Authorized Official - Last Name:MICHALSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC, FACO, DABCO
Authorized Official - Phone:414-778-1900
Mailing Address - Street 1:11407 W. BLUE MOUND RD.
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4031
Mailing Address - Country:US
Mailing Address - Phone:414-778-1900
Mailing Address - Fax:414-778-1759
Practice Address - Street 1:11407 W. BLUE MOUND RD.
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-4031
Practice Address - Country:US
Practice Address - Phone:414-778-1900
Practice Address - Fax:414-778-1759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIT62765Medicare UPIN
WI000075698Medicare PIN