Provider Demographics
NPI:1437829348
Name:CHIRO ONE WELLNESS CENTER OF HUDSON LLC
Entity Type:Organization
Organization Name:CHIRO ONE WELLNESS CENTER OF HUDSON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAHM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-940-0800
Mailing Address - Street 1:PO BOX 74008519
Mailing Address - Street 2:#1406
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-8519
Mailing Address - Country:US
Mailing Address - Phone:630-320-6400
Mailing Address - Fax:630-468-1478
Practice Address - Street 1:1615 MAXWELL DR STE A
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-8712
Practice Address - Country:US
Practice Address - Phone:630-468-1824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-14
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty