Provider Demographics
NPI:1831669407
Name:DEBOER, MARGARET JO (DC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:JO
Last Name:DEBOER
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:W164 N11269 SQUIRE DRIVE SUITE B
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022
Mailing Address - Country:US
Mailing Address - Phone:262-250-1948
Mailing Address - Fax:262-257-9966
Practice Address - Street 1:966 WESTVIEW DR
Practice Address - Street 2:
Practice Address - City:ROCK VALLEY
Practice Address - State:IA
Practice Address - Zip Code:51247-7485
Practice Address - Country:US
Practice Address - Phone:712-476-3355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5342-12111N00000X
IA096128111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor