Fedewa, Diana Marshall

Fedewa, Diana Marshall is an sole proprietor health care provider with primary practice located at 719 Vine St , Wisconsin Dells WI 53965-1621. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Fedewa, Diana Marshall can be contacted via phone (608) 254-4731.

Contact Information

Primary practice address
719 Vine St Wisconsin Dells WI 53965-1621
Fax: (608) 253-9257
Website:

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 3058 Wisconsin

Profile Details

NPI number 1417165473
LBN Legal business name Fedewa, Diana Marshall
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 21st, 2007
Last updated Mar 15th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417165473 NPPES
Wisconsin Other 350037758 RAILROAD MEDICARE

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