Healthcare Provider Details

I. General information

NPI: 1699959551
Provider Name (Legal Business Name): LAKELAND CHIROPRACTIC- OOSTBURG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 S BUSINESS PARK DR STE A7
OOSTBURG WI
53070-1586
US

IV. Provider business mailing address

220 S BUSINESS PARK DR STE A7
OOSTBURG WI
53070-1586
US

V. Phone/Fax

Practice location:
  • Phone: 920-564-6061
  • Fax:
Mailing address:
  • Phone: 920-564-6061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4192-012
License Number StateWI

VIII. Authorized Official

Name: DR. DIRK MATTHEW DULMES
Title or Position: OWNER
Credential: D.C.
Phone: 920-564-6061