Provider Demographics
NPI:1265558225
Name:SPONTAK, WILLIAM DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DAVID
Last Name:SPONTAK
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 10TH AVENUE CT
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WI
Mailing Address - Zip Code:53566-1427
Mailing Address - Country:US
Mailing Address - Phone:608-328-2225
Mailing Address - Fax:608-328-2436
Practice Address - Street 1:765 10TH AVENUE CT
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WI
Practice Address - Zip Code:53566-1427
Practice Address - Country:US
Practice Address - Phone:608-328-2225
Practice Address - Fax:608-328-2436
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2025-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2609111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38848600Medicaid
WI38848600Medicaid
WIU03119Medicare UPIN