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NPI Code Detail

MEDICARE: DR. DAVE LESTER LANGHOLFF D.C.

MEDICARE:  DR. DAVE LESTER LANGHOLFF  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
1111NX0800XOrthopedic Chiropractor1671WI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2350001920OTHERWIRAILROAD MEDICARE

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 : 1952374118
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVE LESTER LANGHOLFF D.C.
Provider Business Mailing Address
First Line : 355 N PETERS AVE
Second Line :
City : FOND DU LAC
State : WI
Zip : 54935-8258
Country : US
Telephone Number : 920-922-9229
Fax Number :
Provider Business Practice Location Address
First Line : 355 N PETERS AVE
Second Line :
City : FOND DU LAC
State : WI
Zip : 54935-8258
Country : US
Telephone Number : 920-922-9229
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2006
Last Update Date : 12/27/2021

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