Organization
WEST BEND CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNI R. HAAK D.C. (OWNER)
(262) 335-4202
Entity
Organization
Contact information
Practice address
1305 CHESTNUT ST, STE 3, WEST BEND, WI 53095-3007
(262) 335-4202
(262) 335-4223
Mailing address
1305 CHESTNUT ST, STE 3, WEST BEND, WI 53095-3007
(262) 335-4202
(262) 335-4223
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3501-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780740308
INDIVIDUAL NPI
WI
05
—
1780740308
—
WI
Enumeration date
03/19/2007
Last updated
01/30/2012
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