Provider Demographics
NPI:1386263374
Name:HEALTH IN MOTION CHIROPRACTIC LLC
Entity type:Organization
Organization Name:HEALTH IN MOTION CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TACHICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-660-6081
Mailing Address - Street 1:3446 JERSEY LANE
Mailing Address - Street 2:OPTIONAL
Mailing Address - City:SUAMICO
Mailing Address - State:WI
Mailing Address - Zip Code:54313
Mailing Address - Country:US
Mailing Address - Phone:920-660-6081
Mailing Address - Fax:
Practice Address - Street 1:2530 LINEVILLE RD STE 1
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54313-8861
Practice Address - Country:US
Practice Address - Phone:920-857-3126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-10
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty