Healthcare Provider Details

I. General information

NPI: 1235187444
Provider Name (Legal Business Name): KILIAN CHIROPRACTIC SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 10/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 PHILLIPS BLVD
SAUK CITY WI
53583
US

IV. Provider business mailing address

515 PHILLIPS BLVD
SAUK CITY WI
53583
US

V. Phone/Fax

Practice location:
  • Phone: 608-643-2744
  • Fax:
Mailing address:
  • Phone: 608-643-2744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2551012
License Number StateWI

VIII. Authorized Official

Name: DR. KARLA DENISE KILIAN
Title or Position: PRESIDENT
Credential: RN DC
Phone: 608-643-2744