MEDICARE: RJHDC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3525 012	WI

General Provider Information

NPI Number	:	1699910224
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RJHDC LLC

Provider Business Mailing Address
First Line	:	717 PHILLIPS BLVD
Second Line	:
City	:	SAUK CITY
State	:	WI
Zip	:	53583-1364
Country	:	US
Telephone Number	:	608-643-8643
Fax Number	:

Provider Business Practice Location Address
First Line	:	707 PHILLIPS BLVD
Second Line	:
City	:	SAUK CITY
State	:	WI
Zip	:	53583-1364
Country	:	US
Telephone Number	:	608-643-8643
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. RANDALL J HOHENSTEIN
Credential	:	DC
Telephone Number	:	608-643-8643

Provider Enumeration Date	:	12/11/2008
Last Update Date	:	12/11/2008

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Directions to “RJHDC LLC ” Practice Location

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