Healthcare Provider Details

I. General information

NPI: 1245395805
Provider Name (Legal Business Name): JUSTIN GALEN SCHARER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 09/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3510 W STEWART AVE
WAUSAU WI
54401
US

IV. Provider business mailing address

3510 W STEWART AVE
WAUSAU WI
54401
US

V. Phone/Fax

Practice location:
  • Phone: 715-848-2710
  • Fax: 715-848-2710
Mailing address:
  • Phone: 715-848-2710
  • Fax: 715-848-2712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4046012
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: