Healthcare Provider Details

I. General information

NPI: 1730376484
Provider Name (Legal Business Name): ELIZABETH ANNE EMERSON D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH ANNE MORGAN D.C.

II. Dates (important events)

Enumeration Date: 09/26/2007
Last Update Date: 05/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8499 STATE HIGHWAY 42
FISH CREEK WI
54212-9419
US

IV. Provider business mailing address

8499 STATE HIGHWAY 42
FISH CREEK WI
54212-9419
US

V. Phone/Fax

Practice location:
  • Phone: 920-868-9280
  • Fax:
Mailing address:
  • Phone: 920-868-9280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4344
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: