Individual
SHANE M MATHISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
326 N. MAIN ST, CADOTT, WI 54727
(715) 252-8521
Mailing address
326 N. MAIN ST, CADOTT, WI 54727
(715) 252-8521
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4182-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38965600
—
WI
Enumeration date
09/15/2006
Last updated
07/08/2007
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