1407113913 NPI number — KARLIK CHIROPRACTIC CENTER, S.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407113913 NPI number — KARLIK CHIROPRACTIC CENTER, S.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KARLIK CHIROPRACTIC CENTER, S.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407113913
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 354
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELKHORN
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53121-0354
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
262-723-2256
Provider Business Mailing Address Fax Number:
262-723-6295

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
850 N WISCONSIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELKHORN
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53121-1137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
262-723-2256
Provider Business Practice Location Address Fax Number:
262-723-6295
Provider Enumeration Date:
04/20/2012

Additional Information

Authorized Official

Authorized Official Last Name:
KARLIK
Authorized Official First Name:
DONN
Authorized Official Middle Name:
FREDERICK
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
262-723-2256

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2887-12 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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