Active Chiropractic Clinic LLC

NPI #1326354077 in Onalaska, Wisconsin

Provider Information

NPI Number: 1326354077
Entity Type: Organization
Organization Name: Active Chiropractic Clinic LLC
Primary Specialty: Chiropractor
Enumeration Date: Aug 19, 2010
Last Updated: Apr 26, 2011

Practice Location

Address: 419 SAND LAKE RD
City: Onalaska
State: Wisconsin
ZIP Code: 54650-2706
Phone: (608) 783-3307

Authorized Official

Name: DR. MARK A CASSELLIUS, D.C.
Title: OWNER
Phone: (608) 783-3307

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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