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General NPI Number Information
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NPI Number | 1437342607
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Entity Type | Individual
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Provider Name | DAVID R BREITBACH D.C.
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Gender | Male
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 128 W JEFFERSON ST
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City | VIROQUA
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State | WI
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Zip | 54665-1533
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Country | US
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Telephone | 608-634-2181
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Fax |
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Provider Business Mailing Address
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Address Line | S3505 PRAIRIE EDGE RD
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City | WESTBY
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State | WI
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Zip | 54667-8234
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Country | US
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Telephone | 608-634-2181
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3800
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License Number State | WI
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