Provider Demographics
NPI:1518354109
Name:WERNLUND, BRADY (DC)
Entity Type:Individual
Prefix:
First Name:BRADY
Middle Name:
Last Name:WERNLUND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 2ND ST STE 102
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-1597
Mailing Address - Country:US
Mailing Address - Phone:715-386-5686
Mailing Address - Fax:
Practice Address - Street 1:516 2ND ST STE 102
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-1597
Practice Address - Country:US
Practice Address - Phone:715-386-5686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI508312111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor