Healthcare Provider Details

I. General information

NPI: 1649726332
Provider Name (Legal Business Name): CHERYL KOELLING D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5939 STATE HIGHWAY 113
WAUNAKEE WI
53597-9551
US

IV. Provider business mailing address

5939 STATE HIGHWAY 113
WAUNAKEE WI
53597-9551
US

V. Phone/Fax

Practice location:
  • Phone: 608-207-8212
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5562-12
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: