Provider Demographics
NPI:1760374219
Name:OUTBACK CHIROPRACTIC LLC
Entity type:Organization
Organization Name:OUTBACK CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:ARVOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-234-3612
Mailing Address - Street 1:2938 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:CHETEK
Mailing Address - State:WI
Mailing Address - Zip Code:54728-8014
Mailing Address - Country:US
Mailing Address - Phone:715-234-3612
Mailing Address - Fax:715-234-1904
Practice Address - Street 1:2938 8TH AVE
Practice Address - Street 2:
Practice Address - City:CHETEK
Practice Address - State:WI
Practice Address - Zip Code:54728-8014
Practice Address - Country:US
Practice Address - Phone:715-234-3612
Practice Address - Fax:715-234-1904
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OUTBACK CHIROPRACTIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty