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General NPI Number Information
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NPI Number | 1033388400
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC COMPLETE SC
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Dates
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Enumeration Date | 02/29/2008
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Last Update Date | 05/22/2013
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Provider Practice Location Address
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Address Line | S74W16845 JANESVILLE RD
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City | MUSKEGO
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State | WI
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Zip | 53150-8618
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Country | US
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Telephone | 414-422-1010
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Fax | 414-422-1040
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Provider Business Mailing Address
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Address Line | S74W16845 JANESVILLE RD
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City | MUSKEGO
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State | WI
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Zip | 53150-8618
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Country | US
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Telephone | 414-422-1010
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Fax | 414-422-1040
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DR. CHRISTOPHER DANIEL CULLIGAN
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Credential | D.C.
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Telephone | 414-422-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4052012
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License Number State | WI
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