Provider Demographics
NPI:1467447995
Name:DREIER, STEPHEN E (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:E
Last Name:DREIER
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 1:601 S 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-3958
Mailing Address - Country:US
Mailing Address - Phone:715-848-1741
Mailing Address - Fax:715-848-2225
Practice Address - Street 1:811 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:WI
Practice Address - Zip Code:54451-1307
Practice Address - Country:US
Practice Address - Phone:715-748-2334
Practice Address - Fax:715-748-1124
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1665111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIP00700888OtherRAILROAD MEDICARE
WI391395063012OtherBCBS
WI38768800Medicaid
WI391395063012OtherBCBS
WI702700009Medicare PIN