MEDICARE: ASPEN CREEK 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
1	111N00000X	Chiropractor	3778012	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871681924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPEN CREEK CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	1268 WEST MAIN STREET
Second Line	:	SUITE 2
City	:	SUN PRAIRIE
State	:	WI
Zip	:	53590-1930
Country	:	US
Telephone Number	:	608-837-2828
Fax Number	:	608-837-0105

Provider Business Practice Location Address
First Line	:	1268 WEST MAIN STREET
Second Line	:	SUITE 2
City	:	SUN PRAIRIE
State	:	WI
Zip	:	53590-1930
Country	:	US
Telephone Number	:	608-837-2828
Fax Number	:	608-837-0105

Authorized Official
Title or Position	:	CHIROPRACTOR OWNER
Name	:	CHRISTINE MARIE STORLEY
Credential	:	DC
Telephone Number	:	608-837-2828

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	08/22/2020

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Directions to “ASPEN CREEK CHIROPRACTIC LLC ” Practice Location

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