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NPI Code Detail

MEDICARE: VARSITY AND COMPANY CHIROPRACTIC LLC

MEDICARE: VARSITY AND COMPANY CHIROPRACTIC 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
1111N00000XChiropractor

General Provider Information

NPI Number : 1801539994
Entity Type Code : Organization
Provider Name (Legal Business Name) : VARSITY AND COMPANY CHIROPRACTIC LLC
Provider Business Mailing Address
First Line : 107 GRANDVIEW CT
Second Line :
City : COLUMBUS
State : WI
Zip : 53925-2329
Country : US
Telephone Number : 920-344-0119
Fax Number :
Provider Business Practice Location Address
First Line : 107 GRANDVIEW CT
Second Line :
City : COLUMBUS
State : WI
Zip : 53925-2329
Country : US
Telephone Number : 920-344-0119
Fax Number :
Authorized Official
Title or Position : DOCTOR OF CHIROPRACTIC
Name : KAILA ALVAREZ
Credential : DC
Telephone Number : 920-344-0119
Provider Enumeration Date : 04/15/2022
Last Update Date : 04/15/2022

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Directions to “VARSITY AND COMPANY CHIROPRACTIC LLC ” Practice Location

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