Provider Demographics
NPI:1669565842
Name:UTSCHIG, MICHAEL R (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:R
Last Name:UTSCHIG
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 1:3070 FISH HATCHERY RD
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53713-3187
Mailing Address - Country:US
Mailing Address - Phone:608-274-2266
Mailing Address - Fax:608-274-1945
Practice Address - Street 1:1 POINT PL STE 104
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-2809
Practice Address - Country:US
Practice Address - Phone:608-662-3831
Practice Address - Fax:608-662-3833
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1808-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38777900Medicaid
WI38777900Medicaid