Provider Demographics
NPI:1508121773
Name:WELL WITHIN CHIROPRACTIC CENTER LLC
Entity Type:Organization
Organization Name:WELL WITHIN CHIROPRACTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATE
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:920-757-6440
Mailing Address - Street 1:N1739 LILY OF THE VALLEY DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:GREENVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54942-9105
Mailing Address - Country:US
Mailing Address - Phone:920-757-6440
Mailing Address - Fax:920-757-6446
Practice Address - Street 1:N1739 LILY OF THE VALLEY DR
Practice Address - Street 2:SUITE 7
Practice Address - City:GREENVILLE
Practice Address - State:WI
Practice Address - Zip Code:54942-9105
Practice Address - Country:US
Practice Address - Phone:920-757-6440
Practice Address - Fax:920-757-6446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-12
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4899-12261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care