Provider Demographics
NPI:1437206844
Name:DRACH CHIROPRACTIC CENTER, LLC
Entity Type:Organization
Organization Name:DRACH CHIROPRACTIC CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DRACH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-384-3010
Mailing Address - Street 1:607 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-4512
Mailing Address - Country:US
Mailing Address - Phone:715-384-3010
Mailing Address - Fax:
Practice Address - Street 1:607 E 3RD ST
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-4512
Practice Address - Country:US
Practice Address - Phone:715-384-3010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1518-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty