Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 5549-12 | WI |
NPI | 1003426495 |
---|---|
Provider Name | Erica Danielle Kiela |
First Address | Plymouth, WI 53073-4004 |
Second Address | Plymouth, WI 53073-4004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2020 |
Last Update Date | 31/07/2020 |