Provider Demographics
NPI:1891004545
Name:AC CHIROPRACTIC LLC
Entity type:Organization
Organization Name:AC CHIROPRACTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:T
Authorized Official - Last Name:CHRISTIANSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:608-588-2242
Mailing Address - Street 1:150 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:SPRING GREEN
Mailing Address - State:WI
Mailing Address - Zip Code:53588-8000
Mailing Address - Country:US
Mailing Address - Phone:608-588-2242
Mailing Address - Fax:608-588-9384
Practice Address - Street 1:150 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:SPRING GREEN
Practice Address - State:WI
Practice Address - Zip Code:53588-8000
Practice Address - Country:US
Practice Address - Phone:608-588-2242
Practice Address - Fax:608-588-9384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3115012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty