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General NPI Number Information
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NPI Number | 1396406435
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Entity Type | Organization
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Legal Business Name | RANDY JOTEN D.C. S.C.
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Dates
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Enumeration Date | 12/30/2021
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Last Update Date | 12/30/2021
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Provider Practice Location Address
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Address Line | 916 HAMMOND AVE
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City | SUPERIOR
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State | WI
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Zip | 54880-1770
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Country | US
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Telephone | 715-392-2476
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Fax |
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Provider Business Mailing Address
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Address Line | 916 HAMMOND AVE
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City | SUPERIOR
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State | WI
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Zip | 54880-1770
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Country | US
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Telephone | 171-539-2247
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RANDY J JOTEN
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Credential | DC
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Telephone | 715-299-0522
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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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