Provider Demographics
NPI:1073996468
Name:JAWORSKI CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:JAWORSKI CHIROPRACTIC LLC
Other - Org Name:JOINT & SPINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSY
Authorized Official - Middle Name:D
Authorized Official - Last Name:JAWORSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-623-2123
Mailing Address - Street 1:2327 NEVA RD
Mailing Address - Street 2:
Mailing Address - City:ANTIGO
Mailing Address - State:WI
Mailing Address - Zip Code:54409-2912
Mailing Address - Country:US
Mailing Address - Phone:715-623-2123
Mailing Address - Fax:715-623-6556
Practice Address - Street 1:2327 NEVA RD
Practice Address - Street 2:
Practice Address - City:ANTIGO
Practice Address - State:WI
Practice Address - Zip Code:54409-2912
Practice Address - Country:US
Practice Address - Phone:715-623-2123
Practice Address - Fax:715-623-6556
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JAWORSKI CHIROPRACTIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-02
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4503-12261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI4503-12OtherWI LICENSE