Provider Demographics
NPI:1043235096
Name:VARISH, GEORGE P III (DC)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:P
Last Name:VARISH
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 S BUSINESS DR
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-6101
Mailing Address - Country:US
Mailing Address - Phone:920-457-6650
Mailing Address - Fax:920-457-0967
Practice Address - Street 1:516 S WISCONSIN DR
Practice Address - Street 2:
Practice Address - City:HOWARDS GROVE
Practice Address - State:WI
Practice Address - Zip Code:53083-1261
Practice Address - Country:US
Practice Address - Phone:920-565-3922
Practice Address - Fax:920-565-2142
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2702111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI2702OtherLICENSE #
WIU13627Medicare UPIN
WI000035640Medicare PIN