Organization
PARKSIDE CHIROPRACTIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY C KIRCHBERG D.C. (CHIROPRACTOR)
(920) 623-2610
Entity
Organization
Contact information
Practice address
1235 PARK AVE, COLUMBUS, WI 53925-1612
(920) 623-2610
Mailing address
1235 PARK AVE, COLUMBUS, WI 53925-1612
(920) 623-2610
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
3989-012
WI
111N00000X
Chiropractor
Primary
70901-012
WI
111N00000X
Chiropractor
70902-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
U43434
—
WI
Enumeration date
07/05/2006
Last updated
08/22/2020
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