Provider Demographics
NPI:1801997275
Name:DALSING, STEPHEN JOHN (DC)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:JOHN
Last Name:DALSING
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 1:1920 JOHN F KENNEDY RD
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-3896
Mailing Address - Country:US
Mailing Address - Phone:563-556-0601
Mailing Address - Fax:563-556-0605
Practice Address - Street 1:1920 JOHN F KENNEDY RD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-3896
Practice Address - Country:US
Practice Address - Phone:563-556-0601
Practice Address - Fax:563-556-0605
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA4379111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI1554Medicare ID - Type Unspecified