MEDICARE: DR. CHARLES JACOB POCHES IV 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	6194-12	WI

General Provider Information

NPI Number	:	1487511192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES JACOB POCHES IV DC

Provider Business Mailing Address
First Line	:	19555 W BLUEMOUND RD STE 14
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53045-5935
Country	:	US
Telephone Number	:	262-649-7876
Fax Number	:

Provider Business Practice Location Address
First Line	:	19555 W BLUEMOUND RD STE 14
Second Line	:
City	:	BROOKFIELD
State	:	WI
Zip	:	53045-5935
Country	:	US
Telephone Number	:	262-649-7876
Fax Number	:

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

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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