Healthcare Provider Details

I. General information

NPI: 1942248851
Provider Name (Legal Business Name): STEVEN C RUPPEL D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 06/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3807 SCHOFIELD AVE
WESTON WI
54476-3748
US

IV. Provider business mailing address

1220 6TH ST
WAUSAU WI
54403-3550
US

V. Phone/Fax

Practice location:
  • Phone: 715-298-3834
  • Fax: 715-298-3834
Mailing address:
  • Phone: 715-298-3834
  • Fax: 715-298-3834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4185-012
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: