Provider Demographics
NPI:1083774152
Name:STOPCZYNSKI, ANDREW C (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:C
Last Name:STOPCZYNSKI
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 1:1624 CLARENCE CT
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-8533
Mailing Address - Country:US
Mailing Address - Phone:262-334-4847
Mailing Address - Fax:262-334-5554
Practice Address - Street 1:1624 CLARENCE CT
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-8533
Practice Address - Country:US
Practice Address - Phone:262-334-4847
Practice Address - Fax:262-334-5554
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3495-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38946700Medicaid
WI38946700Medicaid
WIU72108Medicare UPIN