National Provider Identifier Database

IMAGINE CHIROPRACTIC AND WELLNESS CENTER INC
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

IMAGINE CHIROPRACTIC AND WELLNESS CENTER, INC.
445 CARDINAL LN STE 110
GREEN BAY, WI54313-9577
Phone: 920-327-3752
Fax:
Website:
Specialty Taxonomy Code
* Chiropractor 111N00000X
Sports Physician 111NS0005X

* Indicates primary specialty

NPI Profile & details for IMAGINE CHIROPRACTIC AND WELLNESS CENTER, INC.

NPI Number 1306102066
Legal business name
LBN
IMAGINE CHIROPRACTIC AND WELLNESS CENTER, INC.
Authorized official ANGELA THIELE - (OWNER/CHIROPRACTOR)
Entity Organization
Organization subpart No
Enumeration date 04/06/2012
Last updated 04/06/2012 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • WI License #: 4371-012
  • WI License #: 5028

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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