Organization
FOND DU LAC CHIROPRACTIC & WELLNESS CENTER LLC
Active
Other names
Ideal Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA LYNN SERWE DC (CLINIC OWNER)
(920) 907-1700
Entity
Organization
Contact information
Practice address
976 E JOHNSON ST, STE 900, FOND DU LAC, WI 54935-9746
(920) 907-1700
(920) 907-1708
Mailing address
976 E JOHNSON ST, STE 900, FOND DU LAC, WI 54935-9746
(920) 907-1700
(920) 907-1708
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4174-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38185900
—
WI
Enumeration date
12/22/2008
Last updated
03/18/2009
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