Healthcare Provider Details

I. General information

NPI: 1487841615
Provider Name (Legal Business Name): DUFFY CHIROPRACTIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 N LYNNDALE DR STE 1B
APPLETON WI
54914-3085
US

IV. Provider business mailing address

811 N LYNNDALE DR STE 1B
APPLETON WI
54914-3085
US

V. Phone/Fax

Practice location:
  • Phone: 920-733-9330
  • Fax: 920-733-7220
Mailing address:
  • Phone: 920-733-9330
  • Fax: 920-733-7220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number3260
License Number StateWI

VIII. Authorized Official

Name: SEAN C DUFFY
Title or Position: EMPLOYEE
Credential: DC
Phone: 920-733-9330