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General NPI Number Information
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NPI Number | 1073996468
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Entity Type | Organization
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Legal Business Name | JAWORSKI CHIROPRACTIC LLC
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Dates
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Enumeration Date | 07/02/2015
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Last Update Date | 11/05/2019
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Provider Practice Location Address
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Address Line | 2327 NEVA RD
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City | ANTIGO
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State | WI
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Zip | 54409-2912
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Country | US
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Telephone | 715-623-2123
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Fax | 715-623-6556
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Provider Business Mailing Address
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Address Line | 2327 NEVA RD
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City | ANTIGO
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State | WI
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Zip | 54409-2912
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Country | US
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Telephone | 715-623-2123
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Fax | 715-623-6556
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Authorized Official
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Title or Position | OWNER
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Name | LINDSY D JAWORSKI
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Credential | DC
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Telephone | 715-623-2123
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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 | 4503-12
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License Number State | WI
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