Provider Demographics
NPI:1437102563
Name:BURKHALTER CHIROPRACTIC SC
Entity Type:Organization
Organization Name:BURKHALTER CHIROPRACTIC SC
Other - Org Name:DR RONALD J BURKHALTER AND DR MELANIE ARSENAULT-BURKHALTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARSENAULT-BURKHALTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:608-356-3811
Mailing Address - Street 1:920 8TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913
Mailing Address - Country:US
Mailing Address - Phone:608-356-3811
Mailing Address - Fax:608-356-8011
Practice Address - Street 1:920 8TH AVE
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-1247
Practice Address - Country:US
Practice Address - Phone:608-356-3811
Practice Address - Fax:608-356-8011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3359111N00000X
WI3443111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38896000Medicaid
WI38896000Medicaid
WI0003Medicare ID - Type Unspecified
WI70860Medicare ID - Type Unspecified