Individual
COREY M SANDQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1202 GRAND AVE, WAUSAU, WI 54403-6690
(715) 842-7711
Mailing address
601 S 32ND AVE, WAUSAU, WI 54401-3958
(715) 848-2526
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2345-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26525
SECURITY HEALTH PLAN
—
01
—
350041604
RAILROAD MEDICARE
WI
05
—
38838500
—
WI
01
—
38987500
MEDICAID GROUP
WI
Enumeration date
09/16/2006
Last updated
12/19/2007
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