Wall, Traci
Wall, Traci is an individual health care provider with primary practice located at 864 Rose Dr , Hartland WI 53029-8317. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Wall, Traci can be contacted via phone (262) 367-4523.Contact Information
Primary practice address
864 Rose Dr
Hartland WI 53029-8317
Phone: (262) 367-4523
Fax: (262) 367-4657
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 4199-012 | Wisconsin |
Profile Details
| NPI number | 1053343756 |
|---|---|
| LBN Legal business name | Wall, Traci |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053343756 | NPPES |
| Wisconsin | MEDICAID | 38967000 |
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