Provider Demographics
NPI:1942690151
Name:TRISCUIT, CHAD (ND)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:
Last Name:TRISCUIT
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 N WALWORTH ST
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:WI
Mailing Address - Zip Code:53114-1516
Mailing Address - Country:US
Mailing Address - Phone:828-537-2423
Mailing Address - Fax:
Practice Address - Street 1:124 N WALWORTH ST
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:WI
Practice Address - Zip Code:53114-1516
Practice Address - Country:US
Practice Address - Phone:828-537-2423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-26
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099.0107564175F00000X
AZ15-1489175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath