Provider Demographics
NPI:1063640662
Name:RYGIEL, EDWARD PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:PAUL
Last Name:RYGIEL
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:N6368 912TH ST
Mailing Address - Street 2:
Mailing Address - City:ELK MOUND
Mailing Address - State:WI
Mailing Address - Zip Code:54739-9378
Mailing Address - Country:US
Mailing Address - Phone:715-456-2927
Mailing Address - Fax:
Practice Address - Street 1:205 W MENOMONIE ST
Practice Address - Street 2:
Practice Address - City:ELK MOUND
Practice Address - State:WI
Practice Address - Zip Code:54739-9520
Practice Address - Country:US
Practice Address - Phone:715-879-4480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4513-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor