Provider Demographics
NPI:1932129996
Name:HAMEL, JEFFREY CLEVE (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:CLEVE
Last Name:HAMEL
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 1:1242 W FULTON ST
Mailing Address - Street 2:
Mailing Address - City:WAUPACA
Mailing Address - State:WI
Mailing Address - Zip Code:54981-8236
Mailing Address - Country:US
Mailing Address - Phone:715-258-7444
Mailing Address - Fax:715-258-7844
Practice Address - Street 1:1242 W FULTON ST
Practice Address - Street 2:
Practice Address - City:WAUPACA
Practice Address - State:WI
Practice Address - Zip Code:54981-8236
Practice Address - Country:US
Practice Address - Phone:715-258-7444
Practice Address - Fax:715-258-7844
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3702-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIU88071Medicare UPIN