# AUGUSTA CHIROPRACTIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932545621
- **Authorized official:** CHAD JOHNSON (MEMBER)
- **Authorized official phone:** (715) 286-5515

## Contact information

- **Practice address:** 112 E LINCOLN ST, AUGUSTA, WI 54722-9234
- **Practice address phone:** (715) 286-5515
- **Mailing address:** 112 E LINCOLN ST, AUGUSTA, WI 54722-9234
- **Mailing address phone:** (715) 286-5515

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 3790-012 | WI | Yes |

## Other

- **Enumeration date:** 05/21/2013
- **Last updated:** 05/21/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 38934900 | — | WI |