Provider Demographics
NPI:1215991971
Name:WEBER, ALAN JOHN (DC)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:JOHN
Last Name:WEBER
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 1:601 E BLACKHAWK AVE
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE DU CHIEN
Mailing Address - State:WI
Mailing Address - Zip Code:53821-1651
Mailing Address - Country:US
Mailing Address - Phone:608-326-2511
Mailing Address - Fax:608-326-2167
Practice Address - Street 1:601 E BLACKHAWK AVE
Practice Address - Street 2:
Practice Address - City:PRAIRIE DU CHIEN
Practice Address - State:WI
Practice Address - Zip Code:53821-1651
Practice Address - Country:US
Practice Address - Phone:608-326-2511
Practice Address - Fax:608-326-2167
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3386111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
350038301OtherRAILROAD MEDICARE
391865273012OtherBLUE CROSS BLUE SHIELD
391865273012OtherBLUE CROSS BLUE SHIELD
U62102Medicare UPIN