Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 3653-012 | WI |
NPI | 1013032994 |
---|---|
Provider Name | Dr. Douglas Richard Kratz |
First Address | Stoughton, WI 53589-3331 |
Second Address | Stoughton, WI 53589-2100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 08/07/2007 |