Provider Demographics
NPI:1447357173
Name:STRAMA, DALE J (DC)
Entity type:Individual
Prefix:
First Name:DALE
Middle Name:J
Last Name:STRAMA
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 1:1260 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:WI
Mailing Address - Zip Code:54451-2069
Mailing Address - Country:US
Mailing Address - Phone:715-748-6969
Mailing Address - Fax:
Practice Address - Street 1:1260 S 8TH ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:WI
Practice Address - Zip Code:54451-2069
Practice Address - Country:US
Practice Address - Phone:715-748-6969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2111-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38793600Medicaid
17729OtherSECURITY HEALTH PLAN
WI350038288OtherRAILROAD MEDICARE
CB3715OtherRAILROAD MEDICARE
WI38988000OtherMEDICAID GROUP
17729OtherSECURITY HEALTH PLAN
T63445Medicare UPIN