Provider Demographics
NPI:1780761999
Name:FRANCIS, JEAN MARIE (DC)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:MARIE
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:MARIE
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:1005 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:WI
Mailing Address - Zip Code:53073-1920
Mailing Address - Country:US
Mailing Address - Phone:920-892-4833
Mailing Address - Fax:920-892-2106
Practice Address - Street 1:1005 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:WI
Practice Address - Zip Code:53073-1920
Practice Address - Country:US
Practice Address - Phone:920-892-4833
Practice Address - Fax:920-892-2106
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIWI2969012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000070479Medicare ID - Type Unspecified
U40237Medicare UPIN