Provider Demographics
NPI:1518647742
Name:HILBERT CHIROPRACTIC & WELLNESS LLC
Entity Type:Organization
Organization Name:HILBERT CHIROPRACTIC & WELLNESS LLC
Other - Org Name:HILBERT CHIROPRACTIC & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GAEDTKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:920-973-1323
Mailing Address - Street 1:PO BOX 412
Mailing Address - Street 2:
Mailing Address - City:HILBERT
Mailing Address - State:WI
Mailing Address - Zip Code:54129-0412
Mailing Address - Country:US
Mailing Address - Phone:920-973-1323
Mailing Address - Fax:
Practice Address - Street 1:511 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:HILBERT
Practice Address - State:WI
Practice Address - Zip Code:54129-9490
Practice Address - Country:US
Practice Address - Phone:920-973-1323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-21
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty