Individual
DR. MICHAEL JOHN VANDECASTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
16 N MADISON ST, WAUPUN, WI 53963-1129
(920) 324-8776
(920) 324-8784
Mailing address
PO BOX 283, 16 N. MADISON STREET, WAUPUN, WI 53963-0283
(920) 324-8776
(920) 324-8784
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3212
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3212
LICENSE NUMBER
WI
Enumeration date
02/07/2007
Last updated
07/08/2007
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