Provider Demographics
NPI:1437494929
Name:WELLNESS WAY CHIROPRACTIC
Entity Type:Organization
Organization Name:WELLNESS WAY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:WAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-384-0064
Mailing Address - Street 1:N83W13600 FOND DU LAC AVE
Mailing Address - Street 2:UNIT #221
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-8104
Mailing Address - Country:US
Mailing Address - Phone:262-384-0064
Mailing Address - Fax:
Practice Address - Street 1:10335 W OKLAHOMA AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53227-4100
Practice Address - Country:US
Practice Address - Phone:262-384-0064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4716-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty