Provider Demographics
NPI:1770971608
Name:PROKOP-NETTE, TONYA RAY (DC)
Entity type:Individual
Prefix:DR
First Name:TONYA
Middle Name:RAY
Last Name:PROKOP-NETTE
Suffix:
Gender:F
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:N850 COUNTY ROAD D
Mailing Address - Street 2:
Mailing Address - City:SHELDON
Mailing Address - State:WI
Mailing Address - Zip Code:54766-5004
Mailing Address - Country:US
Mailing Address - Phone:715-314-0445
Mailing Address - Fax:
Practice Address - Street 1:W8646 US HIGHWAY 8
Practice Address - Street 2:
Practice Address - City:LADYSMITH
Practice Address - State:WI
Practice Address - Zip Code:54848-9501
Practice Address - Country:US
Practice Address - Phone:715-532-6394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-30
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5064111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor