Individual
DR. RANDALL W. NODORFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
884 S JANESVILLE ST, SUITE C, WHITEWATER, WI 53190-2508
(262) 472-9115
Mailing address
1920 TOWN HALL RD, BELOIT, WI 53511-9770
(608) 362-7693
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
743131825015
BCBS
WI
Enumeration date
10/19/2006
Last updated
07/08/2007
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