Provider Demographics
NPI:1003678897
Name:LITTLETON, CADE ANTHONY
Entity Type:Individual
Prefix:
First Name:CADE
Middle Name:ANTHONY
Last Name:LITTLETON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219660 BUTTERNUT RD
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:WI
Mailing Address - Zip Code:54484-4339
Mailing Address - Country:US
Mailing Address - Phone:715-316-3994
Mailing Address - Fax:
Practice Address - Street 1:219660 BUTTERNUT RD
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:WI
Practice Address - Zip Code:54484-4339
Practice Address - Country:US
Practice Address - Phone:715-316-3994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
WI390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer