Provider Demographics
NPI:1366585382
Name:FOX CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:FOX CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:608-754-3977
Mailing Address - Street 1:1809 W COX RD
Mailing Address - Street 2:BOX 127
Mailing Address - City:EDGERTON
Mailing Address - State:WI
Mailing Address - Zip Code:53534-8525
Mailing Address - Country:US
Mailing Address - Phone:608-754-3977
Mailing Address - Fax:
Practice Address - Street 1:1809 W COX RD
Practice Address - Street 2:BOX 127
Practice Address - City:EDGERTON
Practice Address - State:WI
Practice Address - Zip Code:53534-8525
Practice Address - Country:US
Practice Address - Phone:608-754-3977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3264111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty