Provider Demographics
NPI:1912194200
Name:BEYOND CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:BEYOND CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:CUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-388-3440
Mailing Address - Street 1:1218 ELLIS ST
Mailing Address - Street 2:
Mailing Address - City:KEWAUNEE
Mailing Address - State:WI
Mailing Address - Zip Code:54216-1826
Mailing Address - Country:US
Mailing Address - Phone:920-388-3440
Mailing Address - Fax:920-388-4560
Practice Address - Street 1:1218 ELLIS ST
Practice Address - Street 2:
Practice Address - City:KEWAUNEE
Practice Address - State:WI
Practice Address - Zip Code:54216-1826
Practice Address - Country:US
Practice Address - Phone:920-388-3440
Practice Address - Fax:920-388-4560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3143111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100092864Medicaid
WI3918512400013OtherBCBS OF WISCONSIN
000070780Medicare PIN