MEDICARE: WEBLEY CHIROPRACTIC CLINIC, S.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	3283-012	WI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	000035912	OTHER	WI	MEDICARE GROUP UNSPECIFIED

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	:	1710040365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEBLEY CHIROPRACTIC CLINIC, S.C.

Provider Business Mailing Address
First Line	:	1050 MILWAUKEE AVE STE 101
Second Line	:	P.O. BOX 698
City	:	BURLINGTON
State	:	WI
Zip	:	53105-1362
Country	:	US
Telephone Number	:	262-763-6000
Fax Number	:	262-763-1886

Provider Business Practice Location Address
First Line	:	1050 MILWAUKEE AVE
Second Line	:	SUITE 101
City	:	BURLINGTON
State	:	WI
Zip	:	53105-1362
Country	:	US
Telephone Number	:	262-763-6000
Fax Number	:	262-763-1886

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMES D WEBLEY JR.
Credential	:	DC
Telephone Number	:	262-763-6000

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	04/01/2014

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Directions to “WEBLEY CHIROPRACTIC CLINIC, S.C. ” Practice Location

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