Provider Demographics
NPI:1336336296
Name:MCCABE CHIROPRACTIC AND WELLNESS CENTER INC
Entity Type:Organization
Organization Name:MCCABE CHIROPRACTIC AND WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCCABE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-386-7690
Mailing Address - Street 1:131 CARMICHAEL RD STE 202
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-8271
Mailing Address - Country:US
Mailing Address - Phone:715-386-7690
Mailing Address - Fax:715-386-7719
Practice Address - Street 1:131 CARMICHAEL RD STE 202
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-8271
Practice Address - Country:US
Practice Address - Phone:715-386-7690
Practice Address - Fax:715-386-7719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3745012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38947800Medicaid
WI38947800Medicaid
WI000070109Medicare PIN
WI=========012OtherBCBS