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General NPI Number Information
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NPI Number | 1174569297
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Entity Type | Organization
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Legal Business Name | JANUSZ CHIROPRACTIC CLINIC, SC
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3113 S 13TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53215-4609
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Country | US
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Telephone | 414-643-6000
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Fax | 414-643-1352
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Provider Business Mailing Address
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Address Line | PO BOX 670
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City | BROOKFIELD
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State | WI
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Zip | 53008-0670
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Country | US
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Telephone | 414-643-6000
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Fax | 414-643-1352
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAYMOND M JANUSZ
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Credential | D.C.
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Telephone | 414-643-6000
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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 | 2411012
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License Number State | WI
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