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General NPI Number Information
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NPI Number | 1164992418
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Entity Type | Organization
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Legal Business Name | LANDON CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 11/29/2018
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Last Update Date | 05/01/2019
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Provider Practice Location Address
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Address Line | 158 E MAIN ST UNIT 1A
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City | REEDSBURG
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State | WI
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Zip | 53959-1973
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Country | US
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Telephone | 608-415-0705
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Fax |
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Provider Business Mailing Address
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Address Line | 1843 TIVOLI CT
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City | REEDSBURG
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State | WI
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Zip | 53959-1469
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Country | US
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Telephone | 608-415-0705
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. ZACHARY LANDON
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Credential | DC
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Telephone | 608-415-0705
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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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