Ballweg, Breanna Rose

Ballweg, Breanna Rose is an individual health care provider with primary practice located at 621 S Gammon Rd , Madison WI 53719-1371. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Ballweg, Breanna Rose can be contacted via phone (608) 630-9040.

Contact Information

Primary practice address
621 S Gammon Rd Madison WI 53719-1371
Phone: (608) 630-9040
Fax: (608) 630-9060
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 4875-12 Wisconsin

Profile Details

NPI number 1467727826
LBN Legal business name Ballweg, Breanna Rose
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 19th, 2012
Last updated Aug 16th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467727826 NPPES
Wisconsin MEDICAID 100022189

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