Provider Demographics
NPI:1063411866
Name:WELNETZ, CURTIS JOHN (DC)
Entity type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:JOHN
Last Name:WELNETZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4096 US HIGHWAY 45
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:WI
Mailing Address - Zip Code:54519-9228
Mailing Address - Country:US
Mailing Address - Phone:715-479-8003
Mailing Address - Fax:715-479-8147
Practice Address - Street 1:4096 US HIGHWAY 45
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:WI
Practice Address - Zip Code:54519-9228
Practice Address - Country:US
Practice Address - Phone:715-479-8003
Practice Address - Fax:715-479-8147
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2476111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38842300Medicaid
T83406Medicare UPIN