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NPI Code Detail

MEDICARE: DR. JOHN E CHURCH DC

MEDICARE: DR. JOHN E CHURCH DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor1444012WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023095064
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN E CHURCH DC
Provider Business Mailing Address
First Line : 1515 MOUNT ZION AVE
Second Line :
City : JANESVILLE
State : WI
Zip : 53545-1111
Country : US
Telephone Number : 608-754-6111
Fax Number : 608-743-2537
Provider Business Practice Location Address
First Line : 1515 MOUNT ZION AVE
Second Line :
City : JANESVILLE
State : WI
Zip : 53545-1111
Country : US
Telephone Number : 608-754-6111
Fax Number : 608-743-2537
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2005
Last Update Date : 08/11/2010

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Directions to “ DR. JOHN E CHURCH DC” Practice Location

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