Organization
KEVIN T SIMONS DC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN T SIMONS DC (OWNER)
(920) 686-7330
Entity
Organization
Contact information
Practice address
2510 WASHINGTON ST, MANITOWOC, WI 54220-4858
(920) 686-7330
(920) 686-7510
Mailing address
2510 WASHINGTON ST, MANITOWOC, WI 54220-4858
(920) 686-7330
(920) 686-7510
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3109
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38888600
—
WI
01
—
P00146537
RAILROAD MEDICARE
WI
Enumeration date
06/12/2008
Last updated
07/21/2008
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