Most Relevant Information
Provider Data
| NPI Number: | 1003257254 |
| Provider Name: | JORDAN MARK KLUEWER D.C. |
| Entity Type: | Individual |
| Taxonomy Code: | 111N00000X |
| Specialty: | Chiropractor |
| License Number: | 4936-12 |
Most Important Dates
| Enumeration Date: | 07/16/2013 |
| Last Updated: | 07/16/2013 |
Provider Practice Location
139 NORTH LAKE STREET
HUSTISFORD
WI
53034
Practice Location Phone/Fax
| Phone: | 9203493233 |
| Fax: |
Provider Mailing Location
PO BOX 325
139 N LAKE ST
HUSTISFORD
WI
53034
Provider Mailing Phone/Fax
| Phone: | 9203493233 |
| Fax: |