Provider Demographics
NPI:1508232125
Name:RISING HEALTH CHIROPRACTIC WELLNESS CORP
Entity Type:Organization
Organization Name:RISING HEALTH CHIROPRACTIC WELLNESS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HAUKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-695-9698
Mailing Address - Street 1:601 RYAN ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-1844
Mailing Address - Country:US
Mailing Address - Phone:262-695-9698
Mailing Address - Fax:262-695-0144
Practice Address - Street 1:601 RYAN ST
Practice Address - Street 2:SUITE F
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-1844
Practice Address - Country:US
Practice Address - Phone:262-695-9698
Practice Address - Fax:262-695-0144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3975-012261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center