MEDICARE: MR. JERRY L ERSCHABEK D.C.

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	393	WY

General Provider Information

NPI Number	:	1588726061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JERRY L ERSCHABEK D.C.

Provider Business Mailing Address
First Line	:	2810 W B ST
Second Line	:
City	:	TORRINGTON
State	:	WY
Zip	:	82240-1940
Country	:	US
Telephone Number	:	307-532-5111
Fax Number	:	307-532-2538

Provider Business Practice Location Address
First Line	:	2810 W B ST
Second Line	:
City	:	TORRINGTON
State	:	WY
Zip	:	82240-1940
Country	:	US
Telephone Number	:	307-532-5111
Fax Number	:	307-532-2538

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

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	03/17/2015

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