Provider Demographics
NPI:1699247841
Name:SHEBOYGAN CHIROPRACTIC LLC
Entity type:Organization
Organization Name:SHEBOYGAN CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:OSLADIL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:920-457-6650
Mailing Address - Street 1:2601 S BUSINESS DR
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-6101
Mailing Address - Country:US
Mailing Address - Phone:920-457-6650
Mailing Address - Fax:
Practice Address - Street 1:2601 S BUSINESS DR
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-6101
Practice Address - Country:US
Practice Address - Phone:920-457-6650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty