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HEALTHSOURCE OF BANGOR S C
NPI 1912167057
Chiropractor in Bangor, WI

Active since June 12, 2008
1505 COMMERCIAL ST, BANGOR, WI 54614(608) 486-4899(608) 486-4661 Get Directions Write a Review

NPPES record last updated: June 12, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Healthsource Of Bangor S C NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEALTHSOURCE OF BANGOR S C (NPI 1912167057) is a healthcare organization registered as a chiropractor in Bangor, Wisconsin and active in the NPI registry since June 2008. The organization lists Jack Anthony Manzella, Doctor Of Chiropractic, as its authorized official.

NPPES Registry Identity

NPI1912167057
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameHEALTHSOURCE OF BANGOR S C
Location Address1505 COMMERCIAL STBangor, WI 54614-0410
Mailing AddressPo Box 410Bangor, WI 54614-0410 · (608) 486-4899 · Fax (608) 486-4661
Phone(608) 486-4899
Fax(608) 486-4661
Organization SubpartNo
Authorized OfficialJack Anthony ManzellaDoctor Of Chiropractic · (608) 486-4899
Enumeration DateJune 12, 2008
✔ NPI 1912167057 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in WI · 2555
Definition
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.
1505 COMMERCIAL ST, Bangor, WI 54614
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALEXANDER MANZELLA D.C.
Chiropractor
1505 COMMERCIAL ST
BANGOR, WI 54614
La Crosse County (608) 486-4899

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Healthsource Of Bangor S C's NPI number?

The NPI number for Healthsource Of Bangor S C is 1912167057. It was assigned to this organization in the NPPES registry on June 12, 2008.

Where is Healthsource Of Bangor S C located?

Healthsource Of Bangor S C is located at 1505 Commercial St, Bangor, WI 54614. The listed phone number is (608) 486-4899.

What is Healthsource Of Bangor S C's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

When was this NPI record last updated?

The NPPES record for Healthsource Of Bangor S C was last updated on June 12, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.