John T Aderholdt, D.C.
Individual provider Active NPI Chiropractor · Pickerel, WI
NPI 1487710075 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1487710075
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2622-012 (WI)
- Practice address
- W9682 E Crystal Lake Rd
Pickerel, WI 54465-9648 - Phone
- (715) 216-6528
- NPI assigned
- Dec 28, 2006
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2622-012 | WI | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2622-012 | WI | Yes |
Addresses
Primary practice location
W9682 E Crystal Lake Rd
Pickerel, WI 54465-9648
Mailing address
W9682 E Crystal Lake Rd
Pickerel, WI 54465-9648
Phone (715) 216-6528
Other names
- Dr. John T Aderholdt
Other providers in Pickerel, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.