Provider Demographics
NPI:1316044043
Name:STRASSER, KATIE J (DC)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:J
Last Name:STRASSER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:J
Other - Last Name:WALDENBERGER
Other - Suffix:
Other - Last Name Type:Former Name
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:54656-2493
Mailing Address - Country:US
Mailing Address - Phone:715-848-2526
Mailing Address - Fax:
Practice Address - Street 1:126 STATE ST
Practice Address - Street 2:BOX 155
Practice Address - City:HOLMEN
Practice Address - State:WI
Practice Address - Zip Code:54636-9508
Practice Address - Country:US
Practice Address - Phone:608-526-4628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3933-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38993400OtherMEDICAID GROUP
WI38948200Medicaid
WI38993400OtherMEDICAID GROUP
U9777Medicare UPIN