Individual
DR. CLINT RYAN DORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
W6905 PARKVIEW DR, SUITE B, GREENVILLE, WI 54942-9099
(920) 757-5771
(920) 757-0373
Mailing address
W6905 PARKVIEW DR, SUITE B, GREENVILLE, WI 54942-9099
(920) 757-5771
(920) 757-0373
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4025012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38956200
—
WI
Enumeration date
12/27/2006
Last updated
09/16/2011
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