Provider Demographics
NPI:1881395051
Name:CHIROPRACTIC HEALTH OF NEENAH, LLC
Entity type:Organization
Organization Name:CHIROPRACTIC HEALTH OF NEENAH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLINT
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:DORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-757-5771
Mailing Address - Street 1:N1724 MUNICIPAL DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54942-8721
Mailing Address - Country:US
Mailing Address - Phone:920-757-5771
Mailing Address - Fax:920-757-0373
Practice Address - Street 1:835 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-2254
Practice Address - Country:US
Practice Address - Phone:920-727-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHIROPRACTIC HEALTH & REHABILITATION CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty