Provider Demographics
NPI:1871634345
Name:CHIROPRACTIC CARE CENTERS, S.C.
Entity Type:Organization
Organization Name:CHIROPRACTIC CARE CENTERS, S.C.
Other - Org Name:CHIROPRACTIC CARE CENTER - WAUKESHA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RHYS
Authorized Official - Middle Name:
Authorized Official - Last Name:MAROHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-467-4384
Mailing Address - Street 1:310 W SAINT PAUL AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-5174
Mailing Address - Country:US
Mailing Address - Phone:262-542-9814
Mailing Address - Fax:262-542-9826
Practice Address - Street 1:310 W SAINT PAUL AVE STE 5
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-5174
Practice Address - Country:US
Practice Address - Phone:262-542-9814
Practice Address - Fax:262-542-9826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty