Individual
DR. KEVIN T SIMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
414 W MAIN ST STE B, SUN PRAIRIE, WI 53590-2912
(920) 860-6426
Mailing address
830 20TH ST, APT 1, PRAIRIE DU SAC, WI 53578-2102
(920) 860-6426
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3109-12
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38888600
—
WI
01
—
P00146537
RAILROAD MEDICARE
WI
Enumeration date
10/03/2006
Last updated
02/02/2023
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