Provider Demographics
NPI:1851511653
Name:KERWIN CHIROPRACTIC, SC
Entity Type:Organization
Organization Name:KERWIN CHIROPRACTIC, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:KERWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:414-282-9001
Mailing Address - Street 1:8081 W LAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-4527
Mailing Address - Country:US
Mailing Address - Phone:414-282-9001
Mailing Address - Fax:414-282-4140
Practice Address - Street 1:8081 W LAYTON AVE
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-3712
Practice Address - Country:US
Practice Address - Phone:414-282-9001
Practice Address - Fax:414-282-4140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3271-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty