Individual
DR. ETHAN A. DULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2343 SILVERNAIL RD, PEWAUKEE, WI 53072-5402
(262) 542-4700
(262) 542-7499
Mailing address
12711 W MEADOW LN, NEW BERLIN, WI 53151-1831
(262) 542-4700
(262) 542-7499
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
3571
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38922600
—
WI
Enumeration date
12/29/2006
Last updated
07/08/2007
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