SearchWisconsin101YA0400X

Richard Dettlaff, BS,CSAC

NPI 1336299817 · on the registry since 2007 · sole proprietor

Practice

Address
514 Riverview Ave
Waukesha, WI 53188
Phone
(262) 548-7666
Fax
(262) 548-7656
Organisation at this address
Waukesha County
Waukesha County
Waukesha County
Waukesha County
Waukesha County
Inferred from a shared address, not stated in the registry.
Clinicians at this address
307

Registry record

Primary taxonomy
101YA0400X
101YA0400X
Licence states on file
WI
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2013-12-10

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin