Provider Demographics
NPI:1457521452
Name:SHULLSBURG CHIROPRACTIC OFFICE, LLC
Entity Type:Organization
Organization Name:SHULLSBURG CHIROPRACTIC OFFICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-266-9167
Mailing Address - Street 1:250 W WATER ST
Mailing Address - Street 2:PO BOX 235
Mailing Address - City:SHULLSBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53586-9470
Mailing Address - Country:US
Mailing Address - Phone:608-965-8600
Mailing Address - Fax:608-965-8601
Practice Address - Street 1:250 W WATER ST
Practice Address - Street 2:
Practice Address - City:SHULLSBURG
Practice Address - State:WI
Practice Address - Zip Code:53586-9470
Practice Address - Country:US
Practice Address - Phone:608-965-8600
Practice Address - Fax:608-965-8601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty