Organization
WILD RIVERS CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB JON DESANTIS DC (OWNER)
(715) 234-3067
Entity
Organization
Contact information
Practice address
1801 W KNAPP ST STE 1, RICE LAKE, WI 54868-1381
(715) 234-3067
(715) 234-3067
Mailing address
16 W JOHN ST STE 3, RICE LAKE, WI 54868-2918
(715) 234-3067
(715) 234-3067
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952878415
—
WI
Enumeration date
06/25/2019
Last updated
04/18/2026
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