OTTO CHIROPRACTIC CLINIC, S.C. (NPI# 1013103225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013103225 |
| Entity Type | Organization |
| Organization Name | OTTO CHIROPRACTIC CLINIC, S.C. |
| Practice Address |
1039 W Mason St Green Bay WI 54303-1842 |
| Practice Telephone | 9209657757 |
| Practice Fax Number | 9207393999 |
| Mailing Telephone | 9209657757 |
| Mailing Fax Number | 9207393999 |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2007-09-20 |
| Authorized Official Name | DR. ANTHONY JAMES OTTO (OWNER/ PRESIDENT/DOCTOR) |
| Authorized Official Telephone | 9209657757 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 12-4315 | WI | Chiropractic Providers |
| Street Address |
1039 W MASON ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-1842 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811068851 | Karen Marie Pleshe | Counselor | 1039 W Mason St, Green Bay, WI 54303-1842 | 2006-11-13 |
| 1609354166 | Phoenix Van Laanen | Social Worker | 1039 W Mason St, Green Bay, WI 54303-1842 | 2018-08-06 |
| 1750898458 | Alicia Wheeler | Social Worker | 1039 W Mason St, Green Bay, WI 54303-1842 | 2018-01-03 |
| 1245756873 | Jordan Lynne Matuszak | Social Worker | 1039 W Mason St, Green Bay, WI 54303-1842 | 2017-08-15 |
| 1144745571 | Seniasor Rodriguez-gomez | Counselor | 1039 W Mason St, Green Bay, WI 54303-1842 | 2017-08-07 |
| 1144742040 | Angela Dawn Schiessl | Counselor | 1039 W Mason St, Green Bay, WI 54303-1842 | 2017-07-12 |
| 1700313673 | Erica Janisch | Social Worker | 1039 W Mason St, Green Bay, WI 54303-1842 | 2017-05-22 |
| 1538692140 | Renee Socker | Counselor | 1039 W Mason St, Green Bay, WI 54303-1842 | 2017-04-10 |
| 1245688993 | Andrea Labine, Ph.d LLC | Psychologist | 1039 W Mason St, 116, Green Bay, WI 54303-1842 | 2016-06-02 |
| 1477908812 | Samantha Jane Mckenzie | Counselor | 1039 W Mason St, Green Bay, WI 54303-1842 | 2016-05-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861916769 | Atlas Spinal Care | Chiropractor | 2069 Central Ct, Suite 11, Green Bay, WI 54311 | 2017-08-01 |
| 1376067413 | Tyler Allen Malueg | Chiropractor | 2069 Central Ct Ste 11, Green Bay, WI 54311-4281 | 2017-07-31 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1982082277 | Matthew Hallam | Chiropractor | 1541 Bellevue St Ste 5, Green Bay, WI 54311-6266 | 2015-05-07 |
| 1861893018 | Leah Hetebrueg | Chiropractor | 2066 Central Dr, Unit D, Green Bay, WI 54311-4244 | 2014-09-08 |
| 1518368836 | Jesse Anderson | Chiropractor | 982 N Taylor St, Green Bay, WI 54303-1202 | 2014-09-05 |
| 1043556780 | Kellen James Binder | Chiropractor | 2638 Tulip Lane, Suite B, Green Bay, WI 54313 | 2012-12-28 |
| 1083980981 | Healthy Living Chiropractic Clinic Inc. | Chiropractor | 858 Hansen Rd, Green Bay, WI 54304-5324 | 2012-03-26 |
| 1730409111 | Cornerstone Chiropractic Sc | Chiropractor | 2763 S Oneida St, Green Bay, WI 54304-5750 | 2010-06-08 |
| 1689906240 | Hazuka Spinal Center Inc | Chiropractor | 1742 E Mason St, Green Bay, WI 54302-3259 | 2010-02-08 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.