Provider Demographics
NPI:1730230699
Name:DUNN CHIROPRACTIC OFFICES SC
Entity type:Organization
Organization Name:DUNN CHIROPRACTIC OFFICES SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-641-4110
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1564012261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000135947Medicare PIN
WIT61818Medicare UPIN