Provider Demographics
NPI:1144627076
Name:ONALASKA FAMILY CHIROPRACTIC WELLNESS CENTER LLC
Entity type:Organization
Organization Name:ONALASKA FAMILY CHIROPRACTIC WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:H
Authorized Official - Last Name:GASCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:608-519-8112
Mailing Address - Street 1:1115 RIDERS CLUB RD
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-2079
Mailing Address - Country:US
Mailing Address - Phone:608-519-8112
Mailing Address - Fax:608-519-8113
Practice Address - Street 1:1115 RIDERS CLUB RD
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-2079
Practice Address - Country:US
Practice Address - Phone:608-519-8112
Practice Address - Fax:608-519-8113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty