Provider Demographics
NPI:1023181484
Name:NYEGGEN, RONALD SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:SCOTT
Last Name:NYEGGEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 335
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:WI
Mailing Address - Zip Code:54011-0335
Mailing Address - Country:US
Mailing Address - Phone:715-273-4404
Mailing Address - Fax:715-273-4406
Practice Address - Street 1:105 NORTH PIETY STREET
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:WI
Practice Address - Zip Code:54011-0335
Practice Address - Country:US
Practice Address - Phone:715-273-4404
Practice Address - Fax:715-273-4406
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1618111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN113T5NYOtherBCBS
GA350051716OtherUNITED HEALTH CARE
MN606147OtherCHIROPRACTIC CARE OF MN
MN113T5NYOtherBCBS
T62891Medicare UPIN