Healthcare Provider Details

I. General information

NPI: 1699720037
Provider Name (Legal Business Name): DRAEGER CHIROPRACTIC OF WESTON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2327 NEVA RD
ANTIGO WI
54409-2912
US

IV. Provider business mailing address

2327 NEVA RD
ANTIGO WI
54409-2912
US

V. Phone/Fax

Practice location:
  • Phone: 715-623-2123
  • Fax: 715-623-6556
Mailing address:
  • Phone: 715-623-2123
  • Fax: 715-623-6556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number2183
License Number StateWI

VIII. Authorized Official

Name: DR. CURT J DRAEGER
Title or Position: OWNER
Credential: D.C.
Phone: 715-623-2123