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Organization
PENINSULA CHIROPRACTIC CENTER INC.
Active
Organization
PENINSULA CHIROPRACTIC CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDAL E ARNOLD D.C. (CLINIC DIRECTOR)
(920) 743-6919
Entity
Organization
Contact information
Practice address
331 KENTUCKY ST, STURGEON BAY, WI 54235-2419
(920) 743-6919
(920) 746-0619
Mailing address
331 KENTUCKY ST, STURGEON BAY, WI 54235-2419
(920) 743-6919
(920) 746-0619
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1763-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003
MEDICARE PROVIDER IDENTIF
—
01
—
38783400
MEDICAID PROVIDER IDENTIF
—
01
—
38995000
MEDICAID PRACTICE IDENTIF
—
Enumeration date
10/10/2007
Last updated
10/10/2007
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