Provider Demographics
NPI:1497972749
Name:DROESSLER CHIROPRACTIC SC
Entity Type:Organization
Organization Name:DROESSLER CHIROPRACTIC SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRENCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:DROESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:9206-223-4743
Mailing Address - Street 1:1349 PARK AVENUE
Mailing Address - Street 2:P O BOX 126
Mailing Address - City:COLUMBUS
Mailing Address - State:WI
Mailing Address - Zip Code:53925
Mailing Address - Country:US
Mailing Address - Phone:920-623-4743
Mailing Address - Fax:
Practice Address - Street 1:1349 PARK AVENUE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:WI
Practice Address - Zip Code:53925
Practice Address - Country:US
Practice Address - Phone:920-623-4743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1494111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1073587465OtherIND NPI
WIBCBSOther482686190000
WIT61806Medicare UPIN