Provider Demographics
NPI:1689735680
Name:NANCY G STOEWE DC SC
Entity Type:Organization
Organization Name:NANCY G STOEWE DC SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:G
Authorized Official - Last Name:STOEWE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-554-5458
Mailing Address - Street 1:6015 DURAND AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53406-5064
Mailing Address - Country:US
Mailing Address - Phone:262-554-5458
Mailing Address - Fax:262-554-7465
Practice Address - Street 1:6015 DURAND AVE STE 500
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53406-5064
Practice Address - Country:US
Practice Address - Phone:262-554-5458
Practice Address - Fax:262-554-7465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T63435Medicare UPIN