Individual
DR. CHARLES LEE NIEUWENHUIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D. C.
Contact information
Practice address
201 W. MAIN ST., HORTONVILLE, WI 54944-0237
(920) 779-4704
Mailing address
PO BOX 237, HORTONVILLE, WI 54944-0237
(920) 779-6032
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1977
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1977
WI CHIROPRACTIC LIC
WI
Enumeration date
08/03/2005
Last updated
07/09/2007
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