Tyjeski, Jerome E
Tyjeski, Jerome E is an sole proprietor health care provider with primary practice located at 119 E Mackie St , Beaver Dam WI 53916-2031. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Tyjeski, Jerome E can be contacted via phone (920) 885-3020.Contact Information
Primary practice address
119 E Mackie St
Beaver Dam WI 53916-2031
Phone: (920) 885-3020
Fax: (920) 885-3024
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 2819 | Wisconsin |
Profile Details
| NPI number | 1104993658 |
|---|---|
| LBN Legal business name | Tyjeski, Jerome E |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 29th, 2006 |
| Last updated | Aug 29th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104993658 | NPPES |
| Wisconsin | MEDICAID | 38861200 |
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