Provider Demographics
NPI:1750684643
Name:WAY, LINSAY JAYMIE (DC)
Entity Type:Individual
Prefix:DR
First Name:LINSAY
Middle Name:JAYMIE
Last Name:WAY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N83W13600 FOND DU LAC AVE
Mailing Address - Street 2:UNIT #221
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-8104
Mailing Address - Country:US
Mailing Address - Phone:262-384-0064
Mailing Address - Fax:
Practice Address - Street 1:10335 W OKLAHOMA AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53227-4100
Practice Address - Country:US
Practice Address - Phone:262-384-0064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-14
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4716-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
357020002Medicare PIN