John Henry Eidem is a Chiropractor in Horicon, Wisconsin. John Henry Eidem practices all healthcare services and medical treatments related to Chiropractor. The NPI Number for John Henry Eidem is 1013992627. The last update date is 2010-07-29.
John Henry Eidem's current location address is 514 E Lake St, Horicon, Wisconsin. You can contact this provider via phone number 9204854009 and fax number 9204850632. The mailing address for John Henry Eidem is 514 E Lake St, Horicon, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John Henry Eidem |
|---|---|
| Address | 514 E Lake St, Horicon, Wisconsin |
| Phone Number | 9204854009 |
| Fax Number | 9204850632 |
| Sole Proprietor | Y |
| Credentials | DC |
NPI Number Detail
| NPI Number | 1013992627 |
|---|---|
| Provider Enumeration Date | 2005-12-07 |
| Last Updated Date | 2010-07-29 |
Provider Mailing Address Detail
| Address | 514 E Lake St |
|---|---|
| City | Horicon |
| State | Wisconsin (WI) |
| Post Code | 530321247 |
| Phone Number | 9204854009 |
| Fax Number | 9204850632 |
Provider's Primary Taxonomy Detail
| Speciality | Chiropractor |
|---|---|
| Taxonomy | 111N00000X |
| Licence No | 2303012 |
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Definition: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its inte |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 38850600 | WI | -- |
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What is the unique identification code assigned to John Henry Eidem by the Centers for Medicare & Medicaid Services?
The John Henry Eidem has been issued the NPI (National Provider Identifier) 1013992627. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the John Henry Eidem's physical address?
The John Henry Eidem is physically located at 514 E Lake St, in the city of Horicon, WI, with the postal code 530321247.
What is the John Henry Eidem's specialty and taxonomy code?
The John Henry Eidem's specialty is Chiropractor, and the corresponding taxonomy code is 111N00000X.
On what date did the John Henry Eidem receive its 1013992627 assignment from the Centers for Medicare & Medicaid Services?
The John Henry Eidem was assigned its 1013992627 by the Centers for Medicare & Medicaid Services on 2005-12-07.
When was the information regarding John Henry Eidem most recently updated?
The details pertaining to the John Henry Eidem, including its address, specialty, and other relevant information, were last refreshed on 2010-07-29.
NPI Number: 1376546309
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