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General NPI Number Information
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NPI Number | 1740307438
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Entity Type | Organization
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Legal Business Name | MCROBERTS CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 03/02/2010
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Provider Practice Location Address
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Address Line | 951 KIMBALL LANE SUITE 122
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City | VERONA
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State | WI
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Zip | 53593
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Country | US
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Telephone | 608-848-0058
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Fax | 608-848-0059
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Provider Business Mailing Address
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Address Line | 951 KIMBALL LANE SUITE 122
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City | VERONA
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State | WI
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Zip | 53593
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Country | US
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Telephone | 608-848-0058
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Fax | 608-848-0059
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIM EDWARD MCROBERTS
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Credential | D.C.
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Telephone | 608-848-0058
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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 | 3755-012
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License Number State | WI
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