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NPI Code Detail

MEDICARE: DENNIS EUGENE SEVERSON D.C.

MEDICARE: DENNIS EUGENE SEVERSON D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor2024WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2391535721014OTHERWIMY BC/BS

General Provider Information

NPI Number : 1376636878
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENNIS EUGENE SEVERSON D.C.
Provider Business Mailing Address
First Line : 154 W LINCOLN ST
Second Line : P.O. BOX 154
City : AUGUSTA
State : WI
Zip : 54722-9152
Country : US
Telephone Number : 715-225-1055
Fax Number : 715-286-5210
Provider Business Practice Location Address
First Line : 154 W LINCOLN ST
Second Line : SUITE 2
City : AUGUSTA
State : WI
Zip : 54722-9152
Country : US
Telephone Number : 715-225-1055
Fax Number : 715-286-5210
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 11/02/2009

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Directions to “ DENNIS EUGENE SEVERSON D.C.” Practice Location

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