Provider Demographics
NPI:1043854854
Name:EFFERTZ CHIROPRACTIC AND WELLNESS CENTER, INC.
Entity Type:Organization
Organization Name:EFFERTZ CHIROPRACTIC AND WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:ELLIOTT
Authorized Official - Last Name:EFFERTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-415-6815
Mailing Address - Street 1:18990 ROUTE 5 W
Mailing Address - Street 2:
Mailing Address - City:EAST DUBUQUE
Mailing Address - State:IL
Mailing Address - Zip Code:61025-9613
Mailing Address - Country:US
Mailing Address - Phone:715-415-6815
Mailing Address - Fax:
Practice Address - Street 1:289 SINSINAWA AVE
Practice Address - Street 2:
Practice Address - City:EAST DUBUQUE
Practice Address - State:IL
Practice Address - Zip Code:61025-1220
Practice Address - Country:US
Practice Address - Phone:815-747-6548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty