Provider Demographics
NPI:1548345739
Name:DUNN, KEVIN SEAN (DC)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:SEAN
Last Name:DUNN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 REGENCY CT
Mailing Address - Street 2:STE 110
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-6166
Mailing Address - Country:US
Mailing Address - Phone:262-641-4110
Mailing Address - Fax:262-641-1858
Practice Address - Street 1:225 REGENCY CT
Practice Address - Street 2:STE 110
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-6166
Practice Address - Country:US
Practice Address - Phone:262-641-4110
Practice Address - Fax:262-641-1858
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1564-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000075274Medicare PIN
WIT61818Medicare UPIN
WI000135947Medicare PIN