Individual
JEDADIAH JOSEPH SCHALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
4068
IA
2085R0202X
Diagnostic Radiology Physician
Primary
49614
WI
2085R0202X
Diagnostic Radiology Physician
52876
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/26/2007
Last updated
09/22/2015
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