Individual
JENNIFER E WAIDELICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
408 KELLER AVE S, AMERY, WI 54001-1220
(715) 268-9146
Mailing address
408 KELLER AVE S, AMERY, WI 54001-1220
(715) 268-9146
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2425
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60671WA
BCBS OF MN
MN
Enumeration date
11/13/2006
Last updated
07/08/2007
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