MEDICARE: PERDZIAK CHIROPRACTIC OFFICE, 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	111NX0800X	Orthopedic Chiropractor	1306-012	WI

General Provider Information

NPI Number	:	1982720868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERDZIAK CHIROPRACTIC OFFICE, S.C.

Provider Business Mailing Address
First Line	:	19 CROSSROADS CT.
Second Line	:	SUITE 101
City	:	DELAFIELD
State	:	WI
Zip	:	53018-2035
Country	:	US
Telephone Number	:	262-646-2640
Fax Number	:	262-646-2650

Provider Business Practice Location Address
First Line	:	19 CROSSROADS CT.
Second Line	:	SUITE 101
City	:	DELAFIELD
State	:	WI
Zip	:	53018-2035
Country	:	US
Telephone Number	:	262-646-2640
Fax Number	:	262-646-2650

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. MICHAEL ANDREW PERDZIAK
Credential	:	D.C., D.A.B.C.O.
Telephone Number	:	262-646-2640

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	08/22/2020

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