Provider Demographics
NPI:1346555109
Name:DENN CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:DENN CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:DENN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-726-0400
Mailing Address - Street 1:4753 COUNTY HIGHWAY J
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-3387
Mailing Address - Country:US
Mailing Address - Phone:715-726-0400
Mailing Address - Fax:715-726-0422
Practice Address - Street 1:4753 COUNTY HIGHWAY J
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-3387
Practice Address - Country:US
Practice Address - Phone:715-726-0400
Practice Address - Fax:715-726-0422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3926-012261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38944600Medicaid
WIU80211Medicare UPIN
WI38944600Medicaid