Provider Demographics
NPI:1578725016
Name:RHYTHM OF LIFE - CHIROPRACTIC FAMILY WELLNESS LLC.
Entity Type:Organization
Organization Name:RHYTHM OF LIFE - CHIROPRACTIC FAMILY WELLNESS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:HAAKENSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-560-4200
Mailing Address - Street 1:W359N5002 BROWN ST
Mailing Address - Street 2:STE. #2
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-3366
Mailing Address - Country:US
Mailing Address - Phone:262-560-4200
Mailing Address - Fax:262-560-4100
Practice Address - Street 1:W359N5002 BROWN ST
Practice Address - Street 2:STE. #2
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-3366
Practice Address - Country:US
Practice Address - Phone:262-560-4200
Practice Address - Fax:262-560-4100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4079111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38964900Medicaid
WI38964900Medicaid
WI000135726Medicare PIN