Riddle, Dustin David

Riddle, Dustin David is an individual health care provider with primary practice located at W2654 County Road Kk , Appleton WI 54915-9468. He recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Riddle, Dustin David can be contacted via phone (920) 830-2221.

Contact Information

Primary practice address
W2654 County Road Kk Appleton WI 54915-9468
Phone: (920) 830-2221
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 3880-012 Wisconsin
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 1127-25 Wisconsin
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 135000875 Illinois

Profile Details

NPI number 1972617629
LBN Legal business name Riddle, Dustin David
Credentials DC,DPM,MHA
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2006
Last updated Apr 26th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972617629 NPPES
Wisconsin MEDICAID 38961800

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