Healthcare Provider Details

I. General information

NPI: 1083756167
Provider Name (Legal Business Name): ROBY CHRISTIAN DORN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W359N5002 BROWN ST STE 220A
OCONOMOWOC WI
53066-3366
US

IV. Provider business mailing address

W359N5002 BROWN ST STE 220A
OCONOMOWOC WI
53066-3366
US

V. Phone/Fax

Practice location:
  • Phone: 262-203-9036
  • Fax: 262-203-9774
Mailing address:
  • Phone: 262-203-9036
  • Fax: 262-203-9774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4053-012
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: