Provider Demographics
NPI:1780900555
Name:KOHN, STEFFANIE (DC)
Entity type:Individual
Prefix:
First Name:STEFFANIE
Middle Name:
Last Name:KOHN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:STEFFANIE
Other - Middle Name:
Other - Last Name:NEMITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:188 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:WI
Mailing Address - Zip Code:53803-9711
Mailing Address - Country:US
Mailing Address - Phone:608-759-6152
Mailing Address - Fax:608-759-6153
Practice Address - Street 1:188 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:WI
Practice Address - Zip Code:53803
Practice Address - Country:US
Practice Address - Phone:608-759-6152
Practice Address - Fax:608-759-6153
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4619-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor