Provider Demographics
NPI:1609802149
Name:RUMSEY, KIM LOUISE (DC)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:LOUISE
Last Name:RUMSEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:LOUISE
Other - Last Name:STRAMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:601 S 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-3958
Mailing Address - Country:US
Mailing Address - Phone:715-848-2526
Mailing Address - Fax:
Practice Address - Street 1:417 N 4TH ST
Practice Address - Street 2:
Practice Address - City:TOMAHAWK
Practice Address - State:WI
Practice Address - Zip Code:54487-1352
Practice Address - Country:US
Practice Address - Phone:715-453-2515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1626-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WICI1364OtherRAILROAD MEDICARE GROUP
WI38988300OtherMEDICAID GROUP
39933OtherSECURITY HEALTH PLAN
WI38764800Medicaid
WI38988300OtherMEDICAID GROUP