Individual
HOWARD DALE POLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
228 N 3RD AVE, WAUSAU, WI 54401-4410
(715) 845-6722
Mailing address
601 S 32ND AVE, WAUSAU, WI 54401-3958
(715) 848-2526
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1404-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13656
SECURITY HEALTH PLAN
—
05
—
38751900
—
WI
01
—
38990400
MEDICAID GROUP
WI
01
—
CB3715
RAILROAD MEDICARE GROUP
WI
01
—
P00203662
RAILROAD MEDICARE
WI
Enumeration date
09/16/2006
Last updated
12/18/2007
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