Individual
KEITH J OUDENHOVEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3020 E COLLEGE AVE, SUITE F, APPLETON, WI 54915-3279
(920) 738-9996
(920) 738-0603
Mailing address
3020 E COLLEGE AVE, SUITE F, APPLETON, WI 54915-3279
(920) 738-9996
(920) 738-0603
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2420-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38894800
—
WI
01
—
P00132309
NETWORK HEALTH PLAN
WI
Enumeration date
06/18/2006
Last updated
07/08/2007
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