Organization
ACTIVE HEALTH EAU CLAIRE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY SOBOROWICZ DC (MEMBER)
(715) 834-6333
Entity
Organization
Contact information
Practice address
3521 LONDON RD, EAU CLAIRE, WI 54701-7861
(715) 834-6333
(715) 831-6374
Mailing address
3521 LONDON RD, EAU CLAIRE, WI 54701-7861
(715) 834-6333
(715) 831-6374
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3103
WI
111N00000X
Chiropractor
3207
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000070863
PTAN
WI
05
—
1104883404
—
WI
05
—
1255442729
—
WI
Enumeration date
04/21/2014
Last updated
04/21/2014
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