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General NPI Number Information
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NPI Number | 1780986703
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Entity Type | Organization
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Legal Business Name | DUMOND CHIROPRACTIC, S.C.
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Dates
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Enumeration Date | 11/23/2010
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Last Update Date | 11/23/2010
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Provider Practice Location Address
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Address Line | 165 N. CENTRAL AVE. SUITE 101
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City | RICHLAND CENTER
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State | WI
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Zip | 53581-0189
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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 | 165 N. CENTRAL AVE. SUITE 101
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City | RICHLAND CENTER
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State | WI
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Zip | 53581-0189
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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 | PRESIDENT
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Name | MATTHEW DUMOND
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Credential |
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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 | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 1377
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License Number State | WI
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