Provider Demographics
NPI:1669791356
Name:ALBIERO CHIROPRACTIC
Entity type:Organization
Organization Name:ALBIERO CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALBIERO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-284-9400
Mailing Address - Street 1:1560 HARRIS DR
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WI
Mailing Address - Zip Code:53024-9003
Mailing Address - Country:US
Mailing Address - Phone:262-284-9400
Mailing Address - Fax:262-284-8999
Practice Address - Street 1:1560 HARRIS DR
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WI
Practice Address - Zip Code:53024-9003
Practice Address - Country:US
Practice Address - Phone:262-284-9400
Practice Address - Fax:262-284-8999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-20
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4458-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty