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General NPI Number Information
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NPI Number | 1720208960
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Entity Type | Individual
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Provider Name | KAREN LYNN DODSON LAC CH DOM
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Gender | Female
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Dates
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Enumeration Date | 04/30/2007
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 4873 MANHATTAN DR
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City | ROCKFORD
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State | IL
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Zip | 61108-2265
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Country | US
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Telephone | 815-977-5876
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Fax | 855-509-0419
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Provider Business Mailing Address
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Address Line | 11809 US HIGHWAY 20
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City | HAMPSHIRE
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State | IL
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Zip | 60140-5000
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Country | US
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Telephone | 608-346-0471
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 197055
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License Number State | WI
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