Provider Demographics
NPI:1700982436
Name:SPANIOL, STEVEN C (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:C
Last Name:SPANIOL
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:715-848-2526
Mailing Address - Fax:
Practice Address - Street 1:600 S MONROE ST
Practice Address - Street 2:
Practice Address - City:NEW LISBON
Practice Address - State:WI
Practice Address - Zip Code:53950-1389
Practice Address - Country:US
Practice Address - Phone:608-562-3373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3074-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI350055557OtherRAILROAD MEDICARE
WICB3715OtherRAILROAD MEDICARE GROUP
WI38996200OtherMEDICAID GROUP
79030OtherSECURITY HEALTH PLAN
WI38996200Medicaid
U64560Medicare UPIN
WI38996200Medicaid