Provider Demographics
NPI:1992848949
Name:CADOTTE, WILLIAM THEODORE (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:THEODORE
Last Name:CADOTTE
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 1:1832 OAK HOLLOW DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-5902
Mailing Address - Country:US
Mailing Address - Phone:231-995-0990
Mailing Address - Fax:231-995-0991
Practice Address - Street 1:1832 OAK HOLLOW DR
Practice Address - Street 2:SUITE B
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-5902
Practice Address - Country:US
Practice Address - Phone:231-995-0990
Practice Address - Fax:231-995-0991
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007713111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950B850490OtherBLUE CROSS BLUE SHIELD
MI0N38570Medicare ID - Type UnspecifiedMEDICARE PROVIDER