Provider Demographics
NPI:1144497645
Name:PREI, DAWN R (DC)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:R
Last Name:PREI
Suffix:
Gender:F
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:PO BOX 1504
Mailing Address - Street 2:
Mailing Address - City:WOODRUFF
Mailing Address - State:WI
Mailing Address - Zip Code:54568-1504
Mailing Address - Country:US
Mailing Address - Phone:715-614-7734
Mailing Address - Fax:
Practice Address - Street 1:8650 US HIGHWAY 51 N
Practice Address - Street 2:
Practice Address - City:MINOCQUA
Practice Address - State:WI
Practice Address - Zip Code:54548-9347
Practice Address - Country:US
Practice Address - Phone:715-614-7734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3134111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38882600Medicaid
WI000070943Medicare UPIN