Organization
PAIN RELIEF CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM LUST (OWNER)
(920) 674-6627
Entity
Organization
Contact information
Practice address
109 E MILWAUKEE ST, JEFFERSON, WI 53549-1635
(920) 674-6627
Mailing address
109 E MILWAUKEE ST, JEFFERSON, WI 53549-1635
(920) 674-6627
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4242-012
WI
Other
Enumeration date
07/25/2013
Last updated
07/25/2013
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