Provider Demographics
NPI:1013286582
Name:DURTSCHE CHIROPRACTIC LTD
Entity Type:Organization
Organization Name:DURTSCHE CHIROPRACTIC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DURTSCHE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:608-788-1170
Mailing Address - Street 1:2045 32ND ST S
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-7026
Mailing Address - Country:US
Mailing Address - Phone:608-788-1170
Mailing Address - Fax:
Practice Address - Street 1:2045 32ND ST S
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-7026
Practice Address - Country:US
Practice Address - Phone:608-788-1170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4781-012261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center