Provider Demographics
NPI:1659484822
Name:FLOOD, DAVID ROBERT (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ROBERT
Last Name:FLOOD
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 1:4751 CTY HWY J
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-3387
Mailing Address - Country:US
Mailing Address - Phone:715-723-2713
Mailing Address - Fax:715-723-1176
Practice Address - Street 1:4751 CTY HWY J
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-3387
Practice Address - Country:US
Practice Address - Phone:715-723-2713
Practice Address - Fax:715-723-1176
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4229012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor