Provider Demographics
NPI:1447358403
Name:WITTERS, STEVEN M (DC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:M
Last Name:WITTERS
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 1:1030 8TH ST
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-1850
Mailing Address - Country:US
Mailing Address - Phone:608-356-2127
Mailing Address - Fax:608-356-1292
Practice Address - Street 1:1030 8TH ST
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-1850
Practice Address - Country:US
Practice Address - Phone:608-356-2127
Practice Address - Fax:608-356-1292
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1559-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor