MEDICARE: DR. TERRENCE C DROESSLER 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
1	111N00000X	Chiropractor	1494	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	391559774	OTHER	WI	TAX ID

General Provider Information

NPI Number	:	1073587465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRENCE C DROESSLER DC

Provider Business Mailing Address
First Line	:	1349 PARK AVE
Second Line	:	P O BOX 126
City	:	COLUMBUS
State	:	WI
Zip	:	53925-1614
Country	:	US
Telephone Number	:	920-623-4743
Fax Number	:

Provider Business Practice Location Address
First Line	:	1349 PARK AVE
Second Line	:
City	:	COLUMBUS
State	:	WI
Zip	:	53925-1614
Country	:	US
Telephone Number	:	920-623-4743
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	08/02/2012

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