Fond Du Lac Family Chiropractic Llc

LBN: Fond Du Lac Family Chiropractic Llc
Fond Du Lac Family Chiropractic Llc is an health care organization with primary practice located at 103 S Pioneer Rd Ste 200 , Fond Du Lac WI 54935-3800. The organization recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as the primary health care specialty. Fond Du Lac Family Chiropractic Llc can be contacted via phone (208) 722-9639, or through Suprenand, Scott via phone (920) 872-2969.

Contact Information

Primary practice address
103 S Pioneer Rd Ste 200 Fond Du Lac WI 54935-3800
Phone: (208) 722-9639
Fax: (920) 933-2511
Website:
Map and Directions
Authorized official contact:
Name: Suprenand, Scott Doctor of Chiropractic (DC)
Phone: (920) 872-2969

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 4745 Wisconsin

Profile Details

NPI number 1790278695
LBN Legal business name Fond Du Lac Family Chiropractic Llc
DBA Doing business as
Authorized official Suprenand, Scott Doctor of Chiropractic (DC)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 14th, 2018
Last updated Dec 28th, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790278695 NPPES
Wisconsin MEDICAID 100014403

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