Jack W Schermerhorn, DC
Individual provider Active NPI Chiropractor · Lacrosse, WI
NPI 1508964776 · NPPES record last updated Oct 1, 2011
Key facts
- NPI
- 1508964776
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1676 (WI)
- Practice address
- 2517 South Ave
Schermerhorn Chiropractic
Lacrosse, WI 54601 - Phone
- (608) 787-8000
- Fax
- (608) 787-8003
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002465 | MN | MD | Acupuncturist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1676 | WI | Yes |
| Chiropractor | 111N00000X | 2465 | MN | |
| Acupuncturist | 171100000X | 002465 | MN |
Addresses
Primary practice location
2517 South Ave
Schermerhorn Chiropractic
Lacrosse, WI 54601
Mailing address
2517 South Ave
Schermerhorn Chiropractic
Lacrosse, WI 54601
Phone (608) 787-8000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4797820 | Other | MN | TAX ID |
| 391396774 | Other | WI | TAX ID |
Other providers in Lacrosse, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.