MEDICARE: BLACK RIVER CHIROPRACTIC CENTER SC

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		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	:	1396746186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLACK RIVER CHIROPRACTIC CENTER SC

Provider Business Mailing Address
First Line	:	126 S 2ND ST
Second Line	:
City	:	BLACK RIVER FALLS
State	:	WI
Zip	:	54615-1726
Country	:	US
Telephone Number	:	715-284-2915
Fax Number	:	715-284-7492

Provider Business Practice Location Address
First Line	:	237 W BROADWAY ST
Second Line	:
City	:	BLAIR
State	:	WI
Zip	:	54616-9366
Country	:	US
Telephone Number	:	608-989-2020
Fax Number	:	608-989-2308

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RUTH V JEAN
Credential	:	DC DABCO
Telephone Number	:	715-284-2915

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	07/21/2022

Similar Medicare Providers

1427058700 — BRIAN J BROST DC
Practice Location Address:

237 W BROADWAY ST
BLAIR, WI
54616-9366

Practice Phone: 608-989-2020
Practice Fax: 608-989-2308

1659372977 — GRAND VIEW CARE CENTER INC
Practice Location Address:

620 GRAND VIEW AVE
BLAIR, WI
54616

Practice Phone: 608-989-2511
Practice Fax: 608-989-2679

1336190941 — GUNDERSEN CLINIC, LTD.
Practice Location Address:

420 S PETERSON AVE
BLAIR, WI
54616-8861

Practice Phone: 608-782-7300
Practice Fax:

1255374468 — HOGDEN ENTERPRISES INC
Practice Location Address:

125 W BROADWAY ST
BLAIR, WI
54616-9367

Practice Phone: 608-989-2919
Practice Fax: 608-989-2837

1740203553 — DR. CHARLES V SMITH D.D.S.
Practice Location Address:

217 E. 4TH ST
BLAIR, WI
54616-0816

Practice Phone: 608-989-2771
Practice Fax: 608-989-9626

1366456709 — BLAIR CHIROPRACTIC CENTER, LLC
Practice Location Address:

237 W. BROADWAY
BLAIR, WI
54616

Practice Phone: 608-989-2020
Practice Fax: 608-989-2308

Directions to “BLACK RIVER CHIROPRACTIC CENTER SC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.