Provider Demographics
NPI:1851060016
Name:MERRILL CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:MERRILL CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:KLUG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-727-3150
Mailing Address - Street 1:1219 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MERRILL
Mailing Address - State:WI
Mailing Address - Zip Code:54452-1203
Mailing Address - Country:US
Mailing Address - Phone:715-727-3150
Mailing Address - Fax:
Practice Address - Street 1:921 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MERRILL
Practice Address - State:WI
Practice Address - Zip Code:54452-2502
Practice Address - Country:US
Practice Address - Phone:715-727-3150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-10
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty