MEDICARE: INGOLF K BARTELS DC

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
1	111N00000X	Chiropractor	1389-12	WI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	350052379	OTHER	WI	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1558589218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INGOLF K BARTELS DC

Provider Business Mailing Address
First Line	:	2640 N 8TH STREET
Second Line	:
City	:	SHEBOYGAN
State	:	WI
Zip	:	53083-4921
Country	:	US
Telephone Number	:	920-452-7600
Fax Number	:	920-452-8270

Provider Business Practice Location Address
First Line	:	2640 N 8TH STREET
Second Line	:
City	:	SHEBOYGAN
State	:	WI
Zip	:	53083-4921
Country	:	US
Telephone Number	:	920-452-7600
Fax Number	:	920-452-8270

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	02/23/2018

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Directions to “ INGOLF K BARTELS DC” Practice Location

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