Provider Demographics
NPI:1053672147
Name:SONDAY, DUSTIN MARK (DC)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:MARK
Last Name:SONDAY
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 1:1419 9TH ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WI
Mailing Address - Zip Code:53566-1423
Mailing Address - Country:US
Mailing Address - Phone:608-325-2626
Mailing Address - Fax:608-325-2504
Practice Address - Street 1:1419 9TH ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WI
Practice Address - Zip Code:53566-1423
Practice Address - Country:US
Practice Address - Phone:608-325-2626
Practice Address - Fax:608-325-2504
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4888111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor