Organization
JANOVICK FAMILY CHIROPRACTIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES MELVIN JANOVICK D.C. (OWNER)
(715) 398-8803
Entity
Organization
Contact information
Practice address
5919 TOWER AVE, SUPERIOR, WI 54880-7226
(715) 398-8803
(715) 398-8804
Mailing address
5919 TOWER AVE, SUPERIOR, WI 54880-7226
(715) 398-8803
(715) 398-8804
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2851-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013R4JA
BCBS INDIVIDUAL NUMBER
WI
01
—
2851-012
WI LICENSE
WI
05
—
38866100
—
WI
01
—
628822
CHIROCARE OF MN
MN
01
—
63I47JA
BCBS GROUP NUMBER
WI
Enumeration date
03/13/2007
Last updated
11/08/2007
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