Provider Demographics
NPI:1326252958
Name:WENZEL, WILLIAM DON (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DON
Last Name:WENZEL
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 1:1111 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-1803
Mailing Address - Country:US
Mailing Address - Phone:608-356-9585
Mailing Address - Fax:608-356-9585
Practice Address - Street 1:1111 8TH ST
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-1803
Practice Address - Country:US
Practice Address - Phone:608-356-9585
Practice Address - Fax:608-356-9585
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1706-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000075459Medicare ID - Type UnspecifiedPROVIDER #