Provider Demographics
NPI:1437380649
Name:JAWORSKI, LINDSY D (DC)
Entity Type:Individual
Prefix:
First Name:LINDSY
Middle Name:D
Last Name:JAWORSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2327 NEVA RD
Mailing Address - Street 2:
Mailing Address - City:ANTIGO
Mailing Address - State:WI
Mailing Address - Zip Code:54409-2912
Mailing Address - Country:US
Mailing Address - Phone:715-623-2123
Mailing Address - Fax:715-623-6556
Practice Address - Street 1:2327 NEVA RD
Practice Address - Street 2:
Practice Address - City:ANTIGO
Practice Address - State:WI
Practice Address - Zip Code:54409-2912
Practice Address - Country:US
Practice Address - Phone:715-623-2123
Practice Address - Fax:715-623-6556
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4503-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100005421Medicaid
K100231246Medicare PIN
WI000735789Medicare PIN