Provider Demographics
NPI:1396101416
Name:ABSOLUTE HEALTH CHIROPRACTIC SC
Entity type:Organization
Organization Name:ABSOLUTE HEALTH CHIROPRACTIC SC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-898-1050
Mailing Address - Street 1:503 S CHERRY AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-4276
Mailing Address - Country:US
Mailing Address - Phone:715-898-1050
Mailing Address - Fax:715-384-6992
Practice Address - Street 1:503 S CHERRY AVE
Practice Address - Street 2:SUITE 111
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-4276
Practice Address - Country:US
Practice Address - Phone:715-898-1050
Practice Address - Fax:715-384-6992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4998111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty