Provider Demographics
NPI:1740426477
Name:DR. ANDREA APPLETON LTD
Entity Type:Organization
Organization Name:DR. ANDREA APPLETON LTD
Other - Org Name:THE CHIROPRACTIC COTTAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WOCHENSKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:920-405-0050
Mailing Address - Street 1:1431 W MASON ST
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54303-2120
Mailing Address - Country:US
Mailing Address - Phone:920-405-0050
Mailing Address - Fax:920-405-0553
Practice Address - Street 1:1431 W MASON ST
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-2120
Practice Address - Country:US
Practice Address - Phone:920-405-0050
Practice Address - Fax:920-405-0553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-31
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4086111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38963900Medicaid
WIU96496Medicare UPIN
WI38963900Medicaid
WI000035813Medicare PIN