Provider Demographics
NPI:1538686837
Name:NEZ ENTERPRISES LLC
Entity Type:Organization
Organization Name:NEZ ENTERPRISES LLC
Other - Org Name:HEALTHSOURCE OF WEST DE PERE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:920-309-6658
Mailing Address - Street 1:1700 SAND ACRES DR STE 2A
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-7562
Mailing Address - Country:US
Mailing Address - Phone:920-309-6658
Mailing Address - Fax:
Practice Address - Street 1:1700 SAND ACRES DR STE 2A
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-7562
Practice Address - Country:US
Practice Address - Phone:920-309-6658
Practice Address - Fax:920-632-2511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-28
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5032-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty