Provider Demographics
NPI:1699852293
Name:VENSKE, RICHARD ALLEN (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALLEN
Last Name:VENSKE
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 1:2725 HILLSIDE DR STE A
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-2165
Mailing Address - Country:US
Mailing Address - Phone:262-646-2123
Mailing Address - Fax:262-646-5615
Practice Address - Street 1:2725 HILLSIDE DR STE A
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-2165
Practice Address - Country:US
Practice Address - Phone:262-646-2123
Practice Address - Fax:262-646-5615
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3384111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000275800Medicare PIN
WIU64953Medicare UPIN