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NPI Code Detail

MEDICARE: DR. WILLIAM JOSEPH BREDAEL B.S., D.C.

MEDICARE:  DR. WILLIAM JOSEPH BREDAEL  B.S., 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
1111N00000XChiropractor4087-012WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285696302
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM JOSEPH BREDAEL B.S., D.C.
Provider Business Mailing Address
First Line : 195 CENTER DR
Second Line : SUITE 102
City : LUXEMBURG
State : WI
Zip : 54217-8395
Country : US
Telephone Number : 920-845-5569
Fax Number : 920-845-5568
Provider Business Practice Location Address
First Line : 195 CENTER DR
Second Line : SUITE 102
City : LUXEMBURG
State : WI
Zip : 54217-8395
Country : US
Telephone Number : 920-845-5569
Fax Number : 920-845-5568
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2006
Last Update Date : 09/24/2012

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Directions to “ DR. WILLIAM JOSEPH BREDAEL B.S., D.C.” Practice Location

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