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General NPI Number Information
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NPI Number | 1295189744
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Entity Type | Organization
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Legal Business Name | DR. MATTHEW DUMOND, LLC
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Dates
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Enumeration Date | 04/21/2016
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Last Update Date | 04/21/2016
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Provider Practice Location Address
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Address Line | 20401 COUNTY HWY SR
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City | RICHLAND CENTER
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State | WI
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Zip | 53581-6266
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Country | US
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Telephone | 608-647-2119
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Fax | 608-647-7539
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Provider Business Mailing Address
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Address Line | 20401 COUNTY HWY SR
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City | RICHLAND CENTER
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State | WI
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Zip | 53581-6266
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Country | US
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Telephone | 608-647-2119
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Fax | 608-647-7539
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | MATTHEW DUMOND
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Credential | D.C.
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Telephone | 608-647-2119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1377
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License Number State | WI
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