Provider Demographics
NPI:1578728499
Name:WYSS, SKIP ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:SKIP
Middle Name:ROBERT
Last Name:WYSS
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 1:295 LAVERNE DR
Mailing Address - Street 2:APT. #8
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-8481
Mailing Address - Country:US
Mailing Address - Phone:715-896-3023
Mailing Address - Fax:
Practice Address - Street 1:2830 CURRY CT
Practice Address - Street 2:SUITE 2
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-4877
Practice Address - Country:US
Practice Address - Phone:715-896-3023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4413-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor