DR. TRAVIS DIEDERICH (NPI# 1760503957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760503957 |
| Entity Type | Individual |
| Full Name | DR. TRAVIS DIEDERICH |
| Credential | D.C. |
| Practice Address |
5901 Morning View Ln Weston WI 54476-3195 |
| Mailing Address |
903 S 17th Ave Suite D Wausau WI 54401-5700 |
| Practice Telephone | 7158456800 |
| Practice Fax Number | 7158452300 |
| Mailing Telephone | 7158456800 |
| Mailing Fax Number | 7158452300 |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2010-04-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 4097 | WI | Chiropractic Providers |
| Street Address |
5901 MORNING VIEW LN |
| City | WESTON |
| State | WI |
| Zip Code | 54476-3195 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407406309 | Kelly Hodge | Technician | 118 Marguerite St, Schofield, WI 54476 | 2019-09-13 |
| 1427557529 | Brandon David Parmer | Licensed Practical Nurse | 134 Kurth St, Schofield, WI 54476 | 2018-02-05 |
| 1558880583 | Kellie Cares Medical, LLC | Non-emergency Medical Transport (VAN) | 4311 Schofield Ave, #97, Weston, WI 54476 | 2017-09-11 |
| 1679018022 | Alexis Legenza | Behavioral Analyst | 4601 Camp Phillips Rd, Weston, WI 54476 | 2016-12-21 |
| 1699176487 | Reenu Mathew | Pharmacist | 5305 U.S. Hwy Business 51, Weston, WI 54476 | 2014-09-11 |
| 1063812246 | Brian Weiland | Psychologist | 2405 Schofield Ave Ste 220, Weston, WI 54476 | 2014-08-25 |
| 1194087759 | Susan C Coady | Physical Therapist | 4605 Valres Springs Court, Weston, WI 54476 | 2012-06-11 |
| 1053437467 | Emmie Jo Kasat | Speech-Language Pathologist | 4605 Valdres Springs Court, Weston, WI 54476 | 2007-03-21 |
| 1326181322 | Lisa Marie Skutak | Dentist | 700 Eagle Nest Boulevard, Suite E, Rothschild, WI 54476 | 2007-02-15 |
| 1205976776 | Quirt Family Dentistry Sc | Dentist | 3417 Schofield Avenue, Schofield, WI 54476 | 2007-02-07 |
| Find all providers in zip 54476 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578054326 | Yussef Chileuitt | Chiropractor | 1084 Golden Cane Dr, Weston, FL 33327-2425 | 2018-05-27 |
| 1427557735 | Allycia Linke | Chiropractor | 5914 Stella Ave, Weston, WI 54476-4210 | 2018-02-02 |
| 1104222074 | Midwest Rehab Center, LLC | Chiropractor | 1670 Island Way, Weston, FL 33326-3624 | 2014-11-05 |
| 1679998041 | Joseph Arena | Chiropractor | 1285 Seabay Rd, Weston, FL 33326-3324 | 2014-02-21 |
| 1659624781 | Matthew David Berry | Chiropractor | 1352 Sw 160th Avenue, Weston, FL 33326-1908 | 2012-10-26 |
| 1174761944 | Craig Steven Donner | Chiropractor | 2475 Provence Cir, Weston, FL 33327-1303 | 2009-02-01 |
| 1548443443 | Shad C Rice | Chiropractor | 235 N River Ave, Weston, WV 26452-1620 | 2007-12-13 |
| 1437354511 | Darran James Hamm | Chiropractor | 2853 Executive Park Dr, Suite 102, Weston, FL 33331-3656 | 2007-06-18 |
| 1740328889 | Elliot Cintron | Chiropractor | 1875 N Corporate Lakes Blvd, Suite 300, Weston, FL 33326-3270 | 2007-02-01 |
| 1962566281 | Elite Chiropractic, P.a. | Chiropractor | 489 Carrington Ln, Weston, FL 33326-3576 | 2006-12-21 |
| Find all providers in WESTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.