Individual
STEVEN EIDEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
514 E LAKE ST, HORICON, WI 53032-1265
(920) 485-4009
(920) 486-0632
Mailing address
514 E LAKE ST, HORICON, WI 53032-1265
(920) 485-4009
(920) 486-0632
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4976-12
WI
Other
Enumeration date
02/11/2014
Last updated
02/11/2014
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