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NPI Code Detail

MEDICARE: DR. SHANNON MICHELLE STADLER D.C.

MEDICARE: DR. SHANNON MICHELLE STADLER 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
1111N00000XChiropractor4613-12WI

General Provider Information

NPI Number : 1023323789
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHANNON MICHELLE STADLER D.C.
Provider Business Mailing Address
First Line : 1452 GENESEE ST
Second Line :
City : DELAFIELD
State : WI
Zip : 53018-1432
Country : US
Telephone Number : 262-646-5800
Fax Number : 262-646-5803
Provider Business Practice Location Address
First Line : 1452 GENESEE ST
Second Line :
City : DELAFIELD
State : WI
Zip : 53018-1432
Country : US
Telephone Number : 262-646-5800
Fax Number : 262-646-5803
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2010
Last Update Date : 08/18/2010

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Directions to “ DR. SHANNON MICHELLE STADLER D.C.” Practice Location

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