Provider Demographics
NPI:1700031044
Name:STEPHEN G. FLIKKE D.C. S.C.
Entity Type:Organization
Organization Name:STEPHEN G. FLIKKE D.C. S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLIKKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-386-4075
Mailing Address - Street 1:2424 MONETARY BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-8737
Mailing Address - Country:US
Mailing Address - Phone:715-386-4075
Mailing Address - Fax:715-387-6406
Practice Address - Street 1:2424 MONETARY BLVD STE 105
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-8737
Practice Address - Country:US
Practice Address - Phone:715-386-4075
Practice Address - Fax:715-387-6406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4442-012111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty