Provider Demographics
NPI:1578117057
Name:NELSON CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:NELSON CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:M
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:608-221-1597
Mailing Address - Street 1:6000 GISHOLT DR STE 102
Mailing Address - Street 2:
Mailing Address - City:MONONA
Mailing Address - State:WI
Mailing Address - Zip Code:53713-4816
Mailing Address - Country:US
Mailing Address - Phone:608-221-1597
Mailing Address - Fax:608-221-1455
Practice Address - Street 1:6000 GISHOLT DR STE 102
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53713-4816
Practice Address - Country:US
Practice Address - Phone:608-221-1597
Practice Address - Fax:608-221-1455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty