Trevor Secraw, D.C.
Individual provider Active NPI Chiropractor · Chetek, WI
NPI 1447823554 · NPPES record last updated Jul 19, 2021
Key facts
- NPI
- 1447823554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 5650-12 (WI)
- Practice address
- 600 1St St
Chetek, WI 54728-4128 - Phone
- (715) 924-2998
- NPI assigned
- Jul 19, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5650-12 | WI | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5650-12 | WI | Yes |
Addresses
Primary practice location
600 1St St
Chetek, WI 54728-4128
Mailing address
1101 19TH St
Cameron, WI 54822-9521
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | info@foundationspfc.com |
Other providers in Chetek, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.