Provider Demographics
NPI:1790982916
Name:DOW, DAVID M (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:DOW
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 1:3310 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-2135
Mailing Address - Country:US
Mailing Address - Phone:608-233-3588
Mailing Address - Fax:608-233-5724
Practice Address - Street 1:3310 UNIVERSITY AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-2135
Practice Address - Country:US
Practice Address - Phone:608-233-3588
Practice Address - Fax:608-233-5724
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3030111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38894200Medicaid
WI38894200Medicaid