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NPI Code Detail

MEDICARE: BARTELS CHIROPRACTIC OFFICE SC

MEDICARE: BARTELS CHIROPRACTIC OFFICE 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
1111N00000XChiropractor1389-012WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1395425842006OTHERWIBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1508040197
Entity Type Code : Organization
Provider Name (Legal Business Name) : BARTELS CHIROPRACTIC OFFICE SC
Provider Business Mailing Address
First Line : 2640 N 8TH STREET
Second Line :
City : SHEBOYGAN
State : WI
Zip : 53083-4921
Country : US
Telephone Number : 920-452-7600
Fax Number : 920-452-8270
Provider Business Practice Location Address
First Line : 2640 N 8TH STREET
Second Line :
City : SHEBOYGAN
State : WI
Zip : 53083-4921
Country : US
Telephone Number : 920-452-7600
Fax Number : 920-452-8270
Authorized Official
Title or Position : OWNER
Name : INGOLF K BARTELS
Credential : DC
Telephone Number : 920-452-7600
Provider Enumeration Date : 12/19/2007
Last Update Date : 03/03/2008

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Directions to “BARTELS CHIROPRACTIC OFFICE SC ” Practice Location

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