Provider Demographics
NPI:1174830244
Name:HABECK, ADAM ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:ROBERT
Last Name:HABECK
Suffix:
Gender:M
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:PO BOX 328
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:54138-0328
Mailing Address - Country:US
Mailing Address - Phone:715-276-3401
Mailing Address - Fax:715-276-1533
Practice Address - Street 1:15267 STATE HWY. 32
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WI
Practice Address - Zip Code:54138
Practice Address - Country:US
Practice Address - Phone:715-276-3401
Practice Address - Fax:715-276-1533
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4633-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor