Provider Demographics
NPI:1841084530
Name:CHIROPRACTIC RESONANCE AND INTEGRATIVE NUTRITION, LLC
Entity type:Organization
Organization Name:CHIROPRACTIC RESONANCE AND INTEGRATIVE NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-225-5620
Mailing Address - Street 1:701 RIVER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53185-3386
Mailing Address - Country:US
Mailing Address - Phone:262-225-5620
Mailing Address - Fax:
Practice Address - Street 1:3064 S KINNICKINNIC AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-2966
Practice Address - Country:US
Practice Address - Phone:414-747-8822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty