Organization
CHURCH CHIROPRACTIC CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN E CHURCH (MANAGING MEMBER)
(608) 754-6111
Entity
Organization
Contact information
Practice address
1515 MOUNT ZION AVE, JANESVILLE, WI 53545-1111
(608) 754-6111
Mailing address
1515 MOUNT ZION AVE, JANESVILLE, WI 53545-1111
(608) 754-6111
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
1444012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38755700
—
WI
Enumeration date
05/23/2008
Last updated
05/23/2008
Update your record
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