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General NPI Number Information
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NPI Number | 1033795604
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Entity Type | Individual
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Provider Name | BRADY SPIELBAUER DC
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Gender | Male
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Dates
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Enumeration Date | 03/23/2021
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Last Update Date | 03/23/2021
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Provider Practice Location Address
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Address Line | 1702 SCHEURING RD STE C
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City | DE PERE
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State | WI
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Zip | 54115-9567
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Country | US
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Telephone | 920-227-1331
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Fax | 920-632-7870
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Provider Business Mailing Address
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Address Line | 1702 SCHEURING RD STE C
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City | DE PERE
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State | WI
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Zip | 54115-9567
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Country | US
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Telephone | 920-227-1331
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Fax | 920-632-7870
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0100X
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Taxonomy Name | Occupational Health Chiropractor
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License Number | 5616-12
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5616-12
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License Number State | WI
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