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Organization
IDEAL CHIROPRACTIC
Active
Organization
IDEAL CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER MILLS D.C. (OWNER)
(920) 994-2000
Entity
Organization
Contact information
Practice address
321 CARROLL STREET, RANDOM LAKE, WI 53075-1795
(920) 994-2000
(920) 994-4953
Mailing address
PO BOX 196, 321 CARROLL STREET, RANDOM LAKE, WI 53075-1795
(920) 994-2000
(920) 994-4953
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4044012
WI
Other
Enumeration date
11/07/2007
Last updated
11/07/2007
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