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General NPI Number Information
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NPI Number | 1952450264
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Entity Type | Organization
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Legal Business Name | JORANDBY CHIROPRACTIC OFFICE, S.C.
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 11/05/2007
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Provider Practice Location Address
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Address Line | 149 N PARK ST
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City | REEDSBURG
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State | WI
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Zip | 53959-1651
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Country | US
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Telephone | 608-524-2213
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Fax |
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Provider Business Mailing Address
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Address Line | 149 N PARK ST
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City | REEDSBURG
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State | WI
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Zip | 53959-1651
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Country | US
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Telephone | 608-524-2213
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. SHELLY JO JORANDBY
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Credential | D.C.
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Telephone | 608-524-2213
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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 | 2310
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License Number State | WI
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