MEDICARE: OMRO CHIROPRACTIC CENTER

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1700470044
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMRO CHIROPRACTIC CENTER

Provider Business Mailing Address
First Line	:	215 JACKSON AVE
Second Line	:
City	:	OMRO
State	:	WI
Zip	:	54963-1429
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 JACKSON AVE
Second Line	:
City	:	OMRO
State	:	WI
Zip	:	54963-1429
Country	:	US
Telephone Number	:	920-685-6788
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CHIROPRACTOR
Name	:	MICHAEL STERTZ
Credential	:	DC
Telephone Number	:	920-685-6788

Provider Enumeration Date	:	02/26/2021
Last Update Date	:	04/14/2021

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Directions to “OMRO CHIROPRACTIC CENTER ” Practice Location

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