PROCARE CHIROPRACTIC CLINIC LTD (NPI# 1023229903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023229903 |
| Entity Type | Organization |
| Organization Name | PROCARE CHIROPRACTIC CLINIC LTD |
| Practice Address |
940 Hansen Rd Ste F Green Bay WI 54304-5377 |
| Practice Telephone | 9204966000 |
| Practice Fax Number | 9204960998 |
| Mailing Telephone | 9204966000 |
| Mailing Fax Number | 9204960998 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2012-03-05 |
| Authorized Official Name | DR. RAY RODDAN (PRESIDENT) |
| Authorized Official Telephone | 9204966000 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 1451 | WI | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 3980300 | 05 |
| Street Address |
940 HANSEN RD STE F |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54304-5377 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932317096 | Scott Harold Wruck | Chiropractor | 940 Hansen Rd, Ste F, Green Bay, WI 54304-5376 | 2007-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689196255 | Kristen Ashley Haltom | Registered Nurse | 2979 Allied St Suite C, Green Bay, WI 54304 | 2017-07-14 |
| 1649671421 | Heather Marie Novak | Counselor | 2979 Allied St Unit C, Green Bay, WI 54304 | 2014-09-11 |
| 1356777684 | Nathan Weir | Specialist/Technologist | 1265 Lombardi Avenue, Green Bay, WI 54304 | 2013-09-18 |
| 1922349927 | John W Hartman | Internal Medicine | 916 Willard Dr, Suite 200, Green Bay, WI 54304 | 2013-03-15 |
| 1447551379 | Citralina M Haruo | Community Health Worker | 1110 11th Avenue, Green Bay, WI 54304 | 2010-11-09 |
| 1497061352 | Daniel James Gustin | Pharmacist | 1109 Lombardi Ave, Green Bay, WI 54304 | 2010-08-28 |
| 1316259898 | Karen A Detrick | Occupational Therapy Assistant | 1040 Pilgram Way, Woodside Senior Communities, Green Bay, WI 54304 | 2010-07-13 |
| 1861667362 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 2605 S. Oneida St. Suite 107, Green Bay, WI 54304 | 2008-04-25 |
| 1891967303 | Kimberley M Welk | Marriage & Family Therapist | 926 Willard Dr Ste 136, Green Bay, WI 54304 | 2008-03-25 |
| 1750563698 | Richard Lawrence Beyer | Hearing Instrument Specialist | 2154 S Ridge Rd, Green Bay, WI 54304 | 2007-12-03 |
| Find all providers in zip 54304 | ||||
| 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.