Healthcare Provider Details

I. General information

NPI: 1194136622
Provider Name (Legal Business Name): ADAM J MCROBERTS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2014
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N AIRPORT RD
PHILLIPS WI
54555-1527
US

IV. Provider business mailing address

126 N LAKE AVE APT 1
PHILLIPS WI
54555-1221
US

V. Phone/Fax

Practice location:
  • Phone: 715-544-0939
  • Fax:
Mailing address:
  • Phone: 701-840-8476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5014-12
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: