# SUN PRAIRIE LASER PAIN CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508562323
- **Authorized official:** DR. KEVIN TODD SIMONS DC (OWNER)
- **Authorized official phone:** (920) 860-6426

## Contact information

- **Practice address:** 414 W MAIN ST STE B, SUN PRAIRIE, WI 53590-2912
- **Practice address phone:** (920) 860-6426
- **Mailing address:** 830 20TH ST APT 1, PRAIRIE DU SAC, WI 53578-2102
- **Mailing address phone:** (920) 860-6426

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | Yes |
| 111N00000X | Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 02/02/2023
- **Last updated:** 02/02/2023