Provider Demographics
NPI:1114182086
Name:HJELTNESS CHIROPRACTIC OFFICE
Entity Type:Organization
Organization Name:HJELTNESS CHIROPRACTIC OFFICE
Other - Org Name:JEFF HJELTNESS, D,C,
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:HJELTNESS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-235-3590
Mailing Address - Street 1:419 2ND ST W
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-1805
Mailing Address - Country:US
Mailing Address - Phone:715-235-3590
Mailing Address - Fax:715-235-3661
Practice Address - Street 1:419 2ND ST W
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-1805
Practice Address - Country:US
Practice Address - Phone:715-235-3590
Practice Address - Fax:715-235-3661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2013-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty