Provider Demographics
NPI:1740438837
Name:ROBB CHIROPRACTIC, S.C.
Entity type:Organization
Organization Name:ROBB CHIROPRACTIC, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:KING
Authorized Official - Last Name:ROBB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:608-222-7731
Mailing Address - Street 1:100 RIVER PL
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MONONA
Mailing Address - State:WI
Mailing Address - Zip Code:53716-4041
Mailing Address - Country:US
Mailing Address - Phone:608-222-7731
Mailing Address - Fax:608-222-7753
Practice Address - Street 1:100 RIVER PL
Practice Address - Street 2:SUITE 210
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53716-4041
Practice Address - Country:US
Practice Address - Phone:608-222-7731
Practice Address - Fax:608-222-7753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1853261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI35151Medicare PIN