Provider Demographics
NPI:1255510764
Name:DEVEAU CHIROPRACTORS INC.
Entity type:Organization
Organization Name:DEVEAU CHIROPRACTORS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:DEVEAU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:414-545-6600
Mailing Address - Street 1:11038 W NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53227-3106
Mailing Address - Country:US
Mailing Address - Phone:414-545-6600
Mailing Address - Fax:414-545-0760
Practice Address - Street 1:11038 W NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-3106
Practice Address - Country:US
Practice Address - Phone:414-545-6600
Practice Address - Fax:414-545-0760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000075740Medicare PIN