WATERTOWN CHIROPRACTIC SC NPI 1972529352

NPI Information

  • NPI: 1972529352
  • Provider Name: WATERTOWN CHIROPRACTIC SC
  • Classification: Chiropractor - 111N00000X
  • Entity Type: Organization
  • CLIA Number: 52D0671035
  • Address: 615 E MAIN ST
    SUITE B
    WATERTOWN, WI
    ZIP 53094
  • Phone: (920) 261-2204

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NPI Details

WATERTOWN CHIROPRACTIC SC is a chiropractor in Watertown, WI. The provider is 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 interrelationship with other body systems. WATERTOWN CHIROPRACTIC SC NPI is 1972529352. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

615 E MAIN ST
SUITE B
WATERTOWN, WI
ZIP 53094-200
Phone: (920) 261-2204
Fax: (920) 261-3901

The provider's authorized official is Jeffrey C Fruendt .
The authorized official title is President Watertown Chiropractic and has the following contact phone number (920) 261-2204.

The CLIA number assigned to this NPI record is 52D0671035 - public health laboratories with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/15/2006 and was last updated on 10/4/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractor3037012WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000035420OTHERWISCONSINMEDICARE ID
2U47848MEDICARE UPIN
338992600MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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