Provider Demographics
NPI:1396002747
Name:JARCHOW FAMILY CHIROPRACTIC SC
Entity Type:Organization
Organization Name:JARCHOW FAMILY CHIROPRACTIC SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:D
Authorized Official - Last Name:JARCHOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-367-6699
Mailing Address - Street 1:510 HARTBROOK DR
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-1440
Mailing Address - Country:US
Mailing Address - Phone:262-367-6699
Mailing Address - Fax:262-367-6701
Practice Address - Street 1:510 HARTBROOK DR
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-1440
Practice Address - Country:US
Practice Address - Phone:262-367-6699
Practice Address - Fax:262-367-6701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1990111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIB84949Medicare UPIN