Provider Demographics
NPI:1437112471
Name:HOLTZ, STEVEN W (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:W
Last Name:HOLTZ
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:N48W14336 HAMPTON RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-6941
Mailing Address - Country:US
Mailing Address - Phone:262-502-0028
Mailing Address - Fax:262-532-4122
Practice Address - Street 1:N48W14336 HAMPTON RD STE 200
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-6941
Practice Address - Country:US
Practice Address - Phone:262-502-0028
Practice Address - Fax:262-532-4122
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1710-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38771500Medicaid
WI38771500Medicaid