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Individual
HOWARD DALE POLAND
Active
Individual
HOWARD DALE POLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1404-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13656
SECURITY HEALTH PLAN
—
05
—
38751900
—
WI
01
—
38990400
MEDICAID GROUP
WI
01
—
CB3715
RAILROAD MEDICARE GROUP
WI
01
—
P00203662
RAILROAD MEDICARE
WI
Enumeration date
09/16/2006
Last updated
12/18/2007
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