Provider Demographics
NPI:1821151127
Name:ALAN W RESCH ENTERPRISES SC
Entity Type:Organization
Organization Name:ALAN W RESCH ENTERPRISES SC
Other - Org Name:CHIROPRACTIC HEALING AND ARTS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:RESCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:920-465-0101
Mailing Address - Street 1:1808 ALLOUEZ AVE STE C
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-6280
Mailing Address - Country:US
Mailing Address - Phone:920-465-0101
Mailing Address - Fax:
Practice Address - Street 1:1808 ALLOUEZ AVE STE C
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-6280
Practice Address - Country:US
Practice Address - Phone:920-465-0101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2074111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1962481564OtherNPI NUMBER
WI38791600Medicaid
WI35107Medicare ID - Type Unspecified
WI38791600Medicaid