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General NPI Number Information
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NPI Number | 1881699387
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Entity Type | Individual
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Provider Name | ANDREW CHATER JUDKINS D.C.
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Gender | Male
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Dates
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Enumeration Date | 06/20/2005
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Last Update Date | 11/17/2020
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Provider Practice Location Address
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Address Line | 421 CAMELOT DR
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City | FOND DU LAC
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State | WI
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Zip | 54935-8335
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Country | US
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Telephone | 920-926-8550
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Fax | 920-926-8058
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Provider Business Mailing Address
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Address Line | 420 E DIVISION ST
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City | FOND DU LAC
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State | WI
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Zip | 54935-4560
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Country | US
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Telephone | 920-926-8340
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Fax | 920-926-8370
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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 | 4008-012
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License Number State | WI
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