Provider Demographics
NPI:1003982802
Name:MEIKE, ALAN DEAN (DC)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:DEAN
Last Name:MEIKE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 W CHESTNUT STREET
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53105
Mailing Address - Country:US
Mailing Address - Phone:262-763-3700
Mailing Address - Fax:262-763-3700
Practice Address - Street 1:196 W CHESTNUT STREET
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53105
Practice Address - Country:US
Practice Address - Phone:262-763-3700
Practice Address - Fax:262-763-3700
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3342111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38892600Medicaid
WI38892600Medicaid
WI355650002Medicare ID - Type Unspecified