Healthcare Provider Details

I. General information

NPI: 1508012014
Provider Name (Legal Business Name): SEKANICK CHIROPRACTIC COMPREHENSIVE SPINAL CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2008
Last Update Date: 07/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4602 S BILTMORE LANE SUITE 100
MADISON WI
53718
US

IV. Provider business mailing address

1967 19TH AVE
RICE LAKE WI
54868-8529
US

V. Phone/Fax

Practice location:
  • Phone: 608-241-1700
  • Fax: 608-241-1705
Mailing address:
  • Phone: 608-241-1700
  • Fax: 608-241-1705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY B SEKANICK
Title or Position: PRESIDENT
Credential:
Phone: 715-234-9211