National Provider Identifier Database

ACTIVE HEALTH EAU CLAIRE
Chiropractor

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.


Contact Information

ACTIVE HEALTH EAU CLAIRE
3521 LONDON RD
EAU CLAIRE, WI54701-7861
Phone: 715-834-6333
Fax: 715-831-6374
Website:
Specialty Taxonomy Code
* Chiropractor 111N00000X

* Indicates primary specialty

NPI Profile & details for ACTIVE HEALTH EAU CLAIRE

NPI Number 1063832798
Legal business name
LBN
ACTIVE HEALTH EAU CLAIRE
Authorized official JUDY SOBOROWICZ - (MEMBER)
Entity Organization
Organization subpart No
Enumeration date 04/21/2014
Last updated 04/21/2014 - About 12 years ago
Sole proprietor1 Not specified
Identifiers
  • WI License #: 3103
  • WI License #: 3207
  • WI Medicaid: 1104883404
  • WI Medicaid: 1255442729
  • WI Other: 000070863 PTAN

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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