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General NPI Number Information
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NPI Number | 1114099462
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Entity Type | Organization
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Legal Business Name | JESSEN FAMILY CHIROPRACTIC CLINIC INC
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 438 N WATER ST
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City | BLACK RIVER FALLS
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State | WI
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Zip | 54615-1005
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Country | US
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Telephone | 715-284-5551
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Fax | 715-284-9164
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Provider Business Mailing Address
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Address Line | 438 N WATER ST
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City | BLACK RIVER FALLS
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State | WI
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Zip | 54615-1005
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Country | US
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Telephone | 715-284-5551
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Fax | 715-284-9164
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Authorized Official
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Title or Position | OWNER
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Name | JAMES D JESSEN
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Credential | DC
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Telephone | 715-284-5551
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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 |
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License Number State |
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