Provider Demographics
NPI:1518265651
Name:KIRWAN, KATHERINE ANNE (DC)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ANNE
Last Name:KIRWAN
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 1:401 SOUTH PELHAM STREET
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501
Mailing Address - Country:US
Mailing Address - Phone:715-362-2300
Mailing Address - Fax:
Practice Address - Street 1:2006 PROGRESS BLVD
Practice Address - Street 2:
Practice Address - City:ANTIGO
Practice Address - State:WI
Practice Address - Zip Code:54409-2475
Practice Address - Country:US
Practice Address - Phone:715-362-2300
Practice Address - Fax:715-362-2305
Is Sole Proprietor?:No
Enumeration Date:2011-03-13
Last Update Date:2017-02-16
Deactivation Date:2013-03-13
Deactivation Code:
Reactivation Date:2017-02-16
Provider Licenses
StateLicense IDTaxonomies
WI4548-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor