Organization
WILKE CHIROPRACTIC OFFICE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER JOHN WILKE DC (OWNER)
(608) 882-4146
Entity
Organization
Contact information
Practice address
503 EAST MAIN STREET, EVANSVILLE, WI 53536-1131
(608) 882-4146
(608) 882-4010
Mailing address
503 EAST MAIN STREET, EVANSVILLE, WI 53536-1131
(608) 882-4146
(608) 882-4010
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3895 012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38941900
—
WI
01
—
534673
DEAN HEALTH PLAN
—
Enumeration date
08/08/2007
Last updated
08/08/2007
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