Provider Demographics
NPI:1124184320
Name:HJELLE, ANTHONY D (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:D
Last Name:HJELLE
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 1:2968 TOWERING PINES DR
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-8879
Mailing Address - Country:US
Mailing Address - Phone:715-362-6908
Mailing Address - Fax:715-362-6502
Practice Address - Street 1:201 E ANDERSON ST
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-3771
Practice Address - Country:US
Practice Address - Phone:715-362-6501
Practice Address - Fax:715-362-6502
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3553-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38909600Medicaid
WI000135423Medicare PIN
WI000175198Medicare PIN