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DE PERE CHIROPRACTIC CENTER LLC NPI 1083600654


NPI Information

NPI: 1083600654
Provider Name: DE PERE CHIROPRACTIC CENTER, LLC

Doing Business As: DE PERE CHIROPRACTIC CENTER

Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
820 GEORGE ST
DE PERE, WI
ZIP 54115
Phone: (920) 336-2921
Get Directions

DE PERE CHIROPRACTIC CENTER, LLC is a chiropractor in De Pere, WI. The provider is 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. DE PERE CHIROPRACTIC CENTER, LLC NPI is 1083600654. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As De Pere Chiropractic Center.

The provider's business location address is:

820 GEORGE ST
DE PERE, WI
ZIP 54115-916
Phone: (920) 336-2921
Fax: (920) 336-8229

The provider's authorized official is Jaceson L. Hauser .
The authorized official title is Owner and has the following contact phone number (920) 336-2921.

The enumeration date for this NPI number is 9/20/2005 and was last updated on 3/21/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractorWISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
138991400MEDICAIDWISCONSIN
2100001401MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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