Individual
AMANDA RAE DIERCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1111 LANGLADE RD, ANTIGO, WI 54409-2738
(715) 623-3761
(715) 623-3764
Mailing address
1111 LANGLADE RD, ANTIGO, WI 54409-2738
(715) 623-3761
(715) 623-3764
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4179-012
WI
Other
Enumeration date
08/30/2006
Last updated
07/31/2007
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