MEDICARE: JANE R KOCOL DC

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	3774012	WI

General Provider Information

NPI Number	:	1811951759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE R KOCOL DC

Provider Business Mailing Address
First Line	:	3160 COUNTY ROAD F
Second Line	:
City	:	FISH CREEK
State	:	WI
Zip	:	54212-9308
Country	:	US
Telephone Number	:	920-421-1900
Fax Number	:

Provider Business Practice Location Address
First Line	:	3906 COUNTY ROAD F
Second Line	:
City	:	FISH CREEK
State	:	WI
Zip	:	54212
Country	:	US
Telephone Number	:	920-421-1900
Fax Number	:

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

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	12/18/2023

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Directions to “ JANE R KOCOL DC” Practice Location

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