Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2878 | WI |
NPI | 1003975046 |
---|---|
Provider Name | Steven A Donley |
First Address | Johnson Creek, WI 53038 |
Second Address | Dousman, WI 53118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
38877600 | (05) | WI |