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Contact Information

WINNEBAGO WELLNESS LLC
102 N 13TH AVE
WINNECONNE, WI54986
 Phone: 920-385-9499
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Chiropractor

111N00000X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for WINNEBAGO WELLNESS LLC

NPI # 1568173326
LBN Legal business name WINNEBAGO WELLNESS LLC
Authorized official ADAM MOOTZ - (CHIROPRACTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 12/12/2022
Last updated 03/14/2023 - About 3 years ago
Identifiers
WI Medicaid 1164820155
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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