MEDICARE: DENN CHIROPRACTIC LLC

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	261QH0100X	Health Service Clinic/Center	3926-012	WI

Other Identifiers

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

General Provider Information

NPI Number	:	1346555109
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENN CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	4753 COUNTY HIGHWAY J
Second Line	:
City	:	CHIPPEWA FALLS
State	:	WI
Zip	:	54729-3387
Country	:	US
Telephone Number	:	715-726-0400
Fax Number	:	715-726-0422

Provider Business Practice Location Address
First Line	:	4753 COUNTY HIGHWAY J
Second Line	:
City	:	CHIPPEWA FALLS
State	:	WI
Zip	:	54729-3387
Country	:	US
Telephone Number	:	715-726-0400
Fax Number	:	715-726-0422

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. JASON SCOTT DENN
Credential	:	DC
Telephone Number	:	715-726-0400

Provider Enumeration Date	:	08/17/2010
Last Update Date	:	12/17/2010

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