Individual
DR. DANIEL JAMES WAUTLET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1071 CORMIER RD, GREEN BAY, WI 54304-4350
(920) 499-0123
(920) 499-5919
Mailing address
1071 CORMIER RD, GREEN BAY, WI 54304-4350
(920) 499-0123
(920) 499-5919
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1597-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38764100
—
WI
Enumeration date
07/16/2006
Last updated
09/25/2012
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