MEDICARE: RASCHKE CHIROPRACTIC CENTER 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
1	111N00000X	Chiropractor	1788-012	WI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	350045133	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	343707	OTHER	WI	EIN#
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750382537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RASCHKE CHIROPRACTIC CENTER SC

Provider Business Mailing Address
First Line	:	304 S WESTERN AVE
Second Line	:
City	:	WAUPACA
State	:	WI
Zip	:	54981-5703
Country	:	US
Telephone Number	:	715-258-8211
Fax Number	:	715-258-0118

Provider Business Practice Location Address
First Line	:	304 S WESTERN AVE
Second Line	:
City	:	WAUPACA
State	:	WI
Zip	:	54981-5703
Country	:	US
Telephone Number	:	715-258-8211
Fax Number	:	715-258-0118

Authorized Official
Title or Position	:	OWNER
Name	:	TYLER B SKIBBA
Credential	:	DC
Telephone Number	:	920-997-9740

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	04/03/2025

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Directions to “RASCHKE CHIROPRACTIC CENTER SC ” Practice Location

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