Individual
DEREK M THIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
4880-12
WI
Other
Enumeration date
04/04/2012
Last updated
06/28/2021
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