Provider Demographics
NPI:1922083112
Name:ROTTIER, DAWN MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:MARIE
Last Name:ROTTIER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1265 MAIN ST
Mailing Address - Street 2:STE 103
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-2884
Mailing Address - Country:US
Mailing Address - Phone:715-254-0233
Mailing Address - Fax:715-254-0235
Practice Address - Street 1:1265 MAIN ST
Practice Address - Street 2:STE 103
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-2884
Practice Address - Country:US
Practice Address - Phone:715-254-0233
Practice Address - Fax:715-254-0235
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3382012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38895900Medicaid
U62638Medicare UPIN
WI38895900Medicaid