Provider Demographics
NPI:1528171519
Name:SCHWEIGHARDT, MARIANNE (DC)
Entity type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:SCHWEIGHARDT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4040 N CALHOUN RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-1336
Mailing Address - Country:US
Mailing Address - Phone:262-783-4044
Mailing Address - Fax:262-783-5498
Practice Address - Street 1:4040 N CALHOUN RD
Practice Address - Street 2:SUITE 103
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-1336
Practice Address - Country:US
Practice Address - Phone:262-783-4044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1371111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
75424Medicare UPIN