Provider Demographics
NPI:1578552683
Name:PALLETT, STEVEN JAMES (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:JAMES
Last Name:PALLETT
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 1:2413 PARMENTER ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-2662
Mailing Address - Country:US
Mailing Address - Phone:608-836-3235
Mailing Address - Fax:608-836-3254
Practice Address - Street 1:2413 PARMENTER ST
Practice Address - Street 2:SUITE 115
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-2662
Practice Address - Country:US
Practice Address - Phone:608-836-3235
Practice Address - Fax:608-836-3254
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3668012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39002700Medicaid
WI39002700Medicaid