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Individual

DR. STUART JOHN BOELTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
1326 ROYALTON ST, WAUPACA, WI 54981-1609
(715) 258-8288
(715) 258-7195
Mailing address
1326 ROYALTON ST, WAUPACA, WI 54981-1609
(715) 258-8288
(715) 258-7195

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3156012
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38885800
WI
01
613541
ACN
01
62411
MULTI PLAN
Enumeration date
10/04/2006
Last updated
07/14/2010
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