Individual
DR. SCOTT M THEIRL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1009 W GLEN OAKS LN, SUITE 207, MEQUON, WI 53092-3377
(800) 385-1655
Mailing address
333 RIVERVIEW DR, THIENSVILLE, WI 53092-1713
(800) 385-1655
Taxonomy
Speciality
Code
Description
License number
State
111NN0400X
Neurology Chiropractor
#X009619
NY
111NN0400X
Neurology Chiropractor
Primary
4227-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WI1690
MEDICARE PTAN
WI
Enumeration date
01/04/2007
Last updated
04/04/2017
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