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NPI Code Detail

MEDICARE: DR. MICHELLE K EVANS D.C.

MEDICARE:  DR. MICHELLE K EVANS  D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor3911WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000335789OTHERWIBCBS SMART VALUE
3610537900OTHERWIUS DEPARTMENT OF LABOR
4000335789OTHERWIUNICARE
599315OTHERWISECURITY HEALTH PLAN
6000335789OTHERWIADVOCARE BY SHP
7000335789OTHERWIHUMANA GOLD CHOICE

General Provider Information

NPI Number : 1083653133
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHELLE K EVANS D.C.
Provider Business Mailing Address
First Line : 601 S 32ND AVE
Second Line :
City : WAUSAU
State : WI
Zip : 54401-3958
Country : US
Telephone Number : 715-848-2526
Fax Number : 715-848-2225
Provider Business Practice Location Address
First Line : 805 W BROADWAY AVE
Second Line :
City : MEDFORD
State : WI
Zip : 54451-1307
Country : US
Telephone Number : 715-748-2334
Fax Number : 715-748-1124
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2006
Last Update Date : 07/21/2022

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Directions to “ DR. MICHELLE K EVANS D.C.” Practice Location

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