Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 2516-012 | WI |
NPI | 1295815561 |
---|---|
Provider Name | Dr. John G Schoenenberger |
First Address | Janesville, WI 53545-0891 |
Second Address | Janesville, WI 53545-0891 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 08/01/2008 |