Healthcare Provider Details
I. General information
NPI: 1447524608
Provider Name (Legal Business Name): JHM CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/05/2012
Last Update Date: 03/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
270 E HIGHLAND AVE SUITE A
MILWAUKEE WI
53202-6635
US
IV. Provider business mailing address
270 E HIGHLAND AVE SUITE A
MILWAUKEE WI
53202-6635
US
V. Phone/Fax
- Phone: 414-220-9441
- Fax: 414-220-9442
- Phone: 414-220-9441
- Fax: 414-220-9442
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 4857-12 |
| License Number State | WI |
VIII. Authorized Official
Name: DR.
JOSEPH
HENRY
MEHRING
Title or Position: DC/OWNER
Credential: D.C.
Phone: 414-238-3207