1760567218 NPI number — PATHWAYS FAMILY CHIROPRACTIC, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760567218 NPI number — PATHWAYS FAMILY CHIROPRACTIC, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PATHWAYS FAMILY CHIROPRACTIC, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760567218
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/06/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
86 COULEE RD
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
HUDSON
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54106-2371
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
715-386-2424
Provider Business Mailing Address Fax Number:
715-386-2426

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
86 COULEE RD
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
HUDSON
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54106-2371
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-386-2424
Provider Business Practice Location Address Fax Number:
715-386-2426
Provider Enumeration Date:
10/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NEMEROW
Authorized Official First Name:
MICHELE
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CHIROPRACTOR/CO-OWNER
Authorized Official Telephone Number:
715-386-2424

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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