Provider Demographics
NPI:1912054842
Name:SEDER, WILLIAM J (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:SEDER
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 1:814 JAY ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4520
Mailing Address - Country:US
Mailing Address - Phone:920-686-0328
Mailing Address - Fax:920-686-1035
Practice Address - Street 1:814 JAY ST
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-4520
Practice Address - Country:US
Practice Address - Phone:920-686-0328
Practice Address - Fax:920-686-1035
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4038-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38953200Medicaid
V00496Medicare UPIN
WI002875562Medicare ID - Type Unspecified