Organization
CREEKSIDE CHIROPRACTIC AND REHABILITATION, LTD.
Active
Other names
Creekside Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW L TISLAU DC (CHIROPRACTOR)
(920) 459-9090
Entity
Organization
Contact information
Practice address
4000 ENTERPRISE DR, SHEBOYGAN, WI 53083-2245
(920) 459-9090
(920) 459-7426
Mailing address
4000 ENTERPRISE DR, SHEBOYGAN, WI 53083-2245
(920) 459-9090
(920) 459-7426
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2308-12
WI
111N00000X
Chiropractor
4058-012
WI
111N00000X
Chiropractor
Primary
4549-12
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38834800
—
WI
Enumeration date
11/07/2007
Last updated
02/08/2024
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