Healthcare Provider Details

I. General information

NPI: 1538323365
Provider Name (Legal Business Name): AFFORDABLE CHIROPRACTIC.BIZ, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 07/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 UNIVERSITY AVE STE 7
GREEN BAY WI
54302-1800
US

IV. Provider business mailing address

1524 UNIVERSITY AVE STE 7
GREEN BAY WI
54302-1800
US

V. Phone/Fax

Practice location:
  • Phone: 920-435-1333
  • Fax:
Mailing address:
  • Phone: 920-435-1333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number3049
License Number StateWI

VIII. Authorized Official

Name: DR. JOHN P JANSSEN
Title or Position: OWNER
Credential: DC
Phone: 920-435-1333