Provider Demographics
NPI:1487675112
Name:STERBA, WILLIAM (DC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:STERBA
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:PO BOX 783
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-0783
Mailing Address - Country:US
Mailing Address - Phone:608-781-2225
Mailing Address - Fax:608-781-2495
Practice Address - Street 1:525 LANG DR
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54603-2946
Practice Address - Country:US
Practice Address - Phone:608-782-2225
Practice Address - Fax:608-782-3486
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1974-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38787500Medicaid
WIP00600197OtherMEDICARE RAILROAD
WI$$$$$$$$$004OtherBLUE CROSS OF WI
WI000170470Medicare PIN
WI38787500Medicaid