Provider Demographics
NPI:1639117351
Name:KADING, ROSS HAYLAND (DC)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:HAYLAND
Last Name:KADING
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 1:501 S PEARL ST
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:WI
Mailing Address - Zip Code:54961-1472
Mailing Address - Country:US
Mailing Address - Phone:920-531-1000
Mailing Address - Fax:920-982-0200
Practice Address - Street 1:501 S PEARL ST
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:WI
Practice Address - Zip Code:54961-1472
Practice Address - Country:US
Practice Address - Phone:920-531-1000
Practice Address - Fax:920-982-0200
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2215111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38798200Medicare ID - Type Unspecified
WIT62362Medicare UPIN