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General NPI Number Information
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NPI Number | 1013286582
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Entity Type | Organization
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Legal Business Name | DURTSCHE CHIROPRACTIC LTD
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Dates
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Enumeration Date | 12/29/2011
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Last Update Date | 12/29/2011
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Provider Practice Location Address
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Address Line | 2045 32ND ST S
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City | LA CROSSE
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State | WI
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Zip | 54601-7026
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Country | US
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Telephone | 608-788-1170
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Fax |
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Provider Business Mailing Address
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Address Line | 2045 32ND ST S
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City | LA CROSSE
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State | WI
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Zip | 54601-7026
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Country | US
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Telephone | 608-788-1170
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CHIROPRACTOR
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Name | DR. MINDY ANN DURTSCHE
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Credential | D.C.
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Telephone | 608-788-1170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 4781-012
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License Number State | WI
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