Individual
DR. CARISSA MARIE JAECKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1620 N SHAWANO ST, STE E, NEW LONDON, WI 54961-9318
(920) 982-5533
Mailing address
702 EISENHOWER DR, STE G, KIMBERLY, WI 54136-2152
(715) 281-4179
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4599-12
WI
Other
Enumeration date
09/01/2010
Last updated
12/01/2017
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