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General NPI Number Information
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NPI Number | 1326558768
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Entity Type | Individual
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Provider Name | JOHN VINCENT DONLON III DC
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Gender | Male
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Dates
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Enumeration Date | 10/11/2017
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 8880 S HOWELL AVE STE 820-840
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City | OAK CREEK
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State | WI
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Zip | 53154-8632
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Country | US
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Telephone | 414-877-3007
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Fax |
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Provider Business Mailing Address
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Address Line | 3855 WOODLAND AVE # 3-01
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City | WEST DES MOINES
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State | IA
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Zip | 50266-1966
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Country | US
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Telephone | 401-525-8035
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 089101
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License Number State | IA
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