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General NPI Number Information
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NPI Number | 1598027385
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Entity Type | Organization
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Legal Business Name | SHARPE CHIROPRACTIC & WELLNESS CLINIC SC
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Dates
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Enumeration Date | 06/08/2012
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Last Update Date | 06/08/2012
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Provider Practice Location Address
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Address Line | 1111 LINDEN DR SUITE 2
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City | HOLMEN
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State | WI
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Zip | 54636-9527
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Country | US
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Telephone | 608-526-9693
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Fax | 608-526-9595
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Provider Business Mailing Address
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Address Line | 1111 LINDEN DR PO BOX 146
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City | HOLMEN
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State | WI
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Zip | 54636-9527
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Country | US
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Telephone | 608-526-9693
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Fax | 608-526-9595
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. LORI MARIE SHARPE
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Credential |
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Telephone | 608-526-9693
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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 | 2346
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License Number State | WI
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