Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 3342 | WI |
NPI | 1003982802 |
---|---|
Provider Name | Alan Dean Meike |
First Address | Burlington, WI 53105 |
Second Address | Burlington, WI 53105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2006 |
Last Update Date | 26/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
38892600 | (05) | WI |
U60652 | (02) |