Healthcare Provider Details

I. General information

NPI: 1730277245
Provider Name (Legal Business Name): PATRICK SHANNON DEWAR DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N1734 MUNICIPAL DR
GREENVILLE WI
54942-8721
US

IV. Provider business mailing address

N1734 MUNICIPAL DR
GREENVILLE WI
54942-8721
US

V. Phone/Fax

Practice location:
  • Phone: 920-757-9999
  • Fax: 920-364-0237
Mailing address:
  • Phone: 920-757-9999
  • Fax: 920-364-0237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3297
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: