Provider Demographics
NPI:1477629137
Name:KURT A SIMONS, DC, SC
Entity Type:Organization
Organization Name:KURT A SIMONS, DC, SC
Other - Org Name:CARE HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-246-3000
Mailing Address - Street 1:N53W24950 S CORPORATE CIR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089-4374
Mailing Address - Country:US
Mailing Address - Phone:262-246-3000
Mailing Address - Fax:262-246-4255
Practice Address - Street 1:N53W24950 S CORPORATE CIR
Practice Address - Street 2:SUITE 2
Practice Address - City:SUSSEX
Practice Address - State:WI
Practice Address - Zip Code:53089-4374
Practice Address - Country:US
Practice Address - Phone:262-246-3000
Practice Address - Fax:262-246-4255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1265549687OtherINDIVIDUAL NPI #
WIU53006Medicare UPIN
WI1265549687OtherINDIVIDUAL NPI #