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Organization
LAKE SUPERIOR CHIROPRACTIC OFFICE, S.C.
Active
Organization
LAKE SUPERIOR CHIROPRACTIC OFFICE, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL D MILLER DC (OWNER)
(715) 398-6679
Entity
Organization
Contact information
Practice address
2121 E 5TH ST, SUPERIOR, WI 54880-3610
(715) 398-6679
(715) 398-6080
Mailing address
2121 E 5TH ST, SUPERIOR, WI 54880-3610
(715) 398-6679
(715) 398-6080
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2460
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38986200
—
WI
Enumeration date
04/20/2007
Last updated
04/29/2008
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