Provider Demographics
NPI:1316008055
Name:VARISH CHIROPRACTIC CLINICS, LLC
Entity Type:Organization
Organization Name:VARISH CHIROPRACTIC CLINICS, LLC
Other - Org Name:HOWARDS GROVE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:LC
Authorized Official - Last Name:VARISH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:920-565-3922
Mailing Address - Street 1:516 S WISCONSIN DR
Mailing Address - Street 2:
Mailing Address - City:HOWARDS GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53083-1261
Mailing Address - Country:US
Mailing Address - Phone:920-565-3922
Mailing Address - Fax:920-565-2142
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2910111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000035640Medicare PIN