Provider Demographics
NPI:1912396862
Name:COOK AND HENRIKSEN CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:COOK AND HENRIKSEN CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LONA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:7158-089-3333
Mailing Address - Street 1:529 2ND ST
Mailing Address - Street 2:STE D
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-1561
Mailing Address - Country:US
Mailing Address - Phone:715-808-9333
Mailing Address - Fax:
Practice Address - Street 1:529 2ND ST
Practice Address - Street 2:STE D
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-1561
Practice Address - Country:US
Practice Address - Phone:715-808-9333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-15
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty