Provider Demographics
NPI:1265549687
Name:SIMONS, KURT (DC)
Entity type:Individual
Prefix:DR
First Name:KURT
Middle Name:
Last Name:SIMONS
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:N14W23833 STONE RIDGE DR STE 360
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1125
Mailing Address - Country:US
Mailing Address - Phone:262-246-3000
Mailing Address - Fax:262-910-4945
Practice Address - Street 1:N14W23833 STONE RIDGE DR STE 360
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1125
Practice Address - Country:US
Practice Address - Phone:262-246-3000
Practice Address - Fax:262-246-4255
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIWI2342Medicare PIN
WIU53006Medicare UPIN