Provider Demographics
NPI:1184225815
Name:POWERS, MICHAELA R (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAELA
Middle Name:R
Last Name:POWERS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 CLARMAR DR
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-2675
Mailing Address - Country:US
Mailing Address - Phone:608-274-1945
Mailing Address - Fax:608-318-5922
Practice Address - Street 1:1633 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-1839
Practice Address - Country:US
Practice Address - Phone:608-837-7712
Practice Address - Fax:608-825-6638
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5573111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor