Individual
BROOKE AMBER HUETTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
415 W WISCONSIN ST, SUITE 4, SPARTA, WI 54656-2492
(608) 269-4511
(608) 269-8511
Mailing address
415 W WISCONSIN ST, STE 4, SPARTA, WI 54656-2492
(608) 269-4511
(608) 269-8511
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4156-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38964000
—
WI
01
—
38984600
MEDICAID GROUP
WI
01
—
391794159330
ANTHEMBCBS
—
Enumeration date
06/21/2006
Last updated
05/19/2015
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