Provider Demographics
NPI:1649452483
Name:ADVANCE CHIROPRACTIC HEALTH CENTER, INC.
Entity type:Organization
Organization Name:ADVANCE CHIROPRACTIC HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHIAVO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:920-733-0200
Mailing Address - Street 1:2308 W NORDALE DR
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-1887
Mailing Address - Country:US
Mailing Address - Phone:920-733-0200
Mailing Address - Fax:920-733-8512
Practice Address - Street 1:2308 W NORDALE DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-1887
Practice Address - Country:US
Practice Address - Phone:920-733-0200
Practice Address - Fax:920-733-8512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2607111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty