Provider Demographics
NPI:1659634152
Name:OSSEO CHIROPRACTIC AND HEALTH CENTER LLC
Entity Type:Organization
Organization Name:OSSEO CHIROPRACTIC AND HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALECKSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-597-3388
Mailing Address - Street 1:PO BOX 625
Mailing Address - Street 2:13818 7TH. ST.
Mailing Address - City:OSSEO
Mailing Address - State:WI
Mailing Address - Zip Code:54758-0625
Mailing Address - Country:US
Mailing Address - Phone:715-597-3388
Mailing Address - Fax:715-597-2688
Practice Address - Street 1:13818 7TH ST
Practice Address - Street 2:
Practice Address - City:OSSEO
Practice Address - State:WI
Practice Address - Zip Code:54758-7402
Practice Address - Country:US
Practice Address - Phone:715-597-3388
Practice Address - Fax:715-597-2688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-19
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4767-014111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty