Individual
LORELEI N WAKEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
500 BIRCH ST, PARK FALLS, WI 54552-1415
(715) 762-2950
Mailing address
500 BIRCH ST, PARK FALLS, WI 54552-1415
(715) 762-2950
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2475-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30756
SECURITY HEALTH PLAN
—
01
—
350043137
RAILROAD MEDICARE
WI
05
—
38847500
—
WI
01
—
38987800
MEDICAID GROUP
WI
01
—
CI2400
RAILROAD MEDICARE GROUP
WI
Enumeration date
09/26/2006
Last updated
01/27/2017
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