Provider Demographics
NPI:1235471442
Name:HOWE, VALERIA MAE (DC)
Entity Type:Individual
Prefix:MS
First Name:VALERIA
Middle Name:MAE
Last Name:HOWE
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 1:415 W WISCONSIN ST
Mailing Address - Street 2:STE 4
Mailing Address - City:SPARTA
Mailing Address - State:WI
Mailing Address - Zip Code:54656-2492
Mailing Address - Country:US
Mailing Address - Phone:608-269-4511
Mailing Address - Fax:608-269-8511
Practice Address - Street 1:415 W WISCONSIN ST
Practice Address - Street 2:STE 4
Practice Address - City:SPARTA
Practice Address - State:WI
Practice Address - Zip Code:54656-2492
Practice Address - Country:US
Practice Address - Phone:608-269-4511
Practice Address - Fax:608-269-8511
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-26
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5200-12111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI5200-12OtherWI LICENSE
WI1235471442Medicaid