DR. BRANDON ALLEN DYRDAHL (NPI# 1437714805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437714805 |
| Entity Type | Individual |
| Full Name | DR. BRANDON ALLEN DYRDAHL |
| Credential | DC |
| Practice Address |
2006 Progress Blvd Antigo WI 54409-2475 |
| Practice Telephone | 7156235481 |
| Practice Fax Number | 7156270177 |
| Mailing Telephone | 7156235481 |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2019-10-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 5470-12 | WI | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | CLINIC NPI | 1891904793 | 01 |
| Street Address |
2006 PROGRESS BLVD |
| City | ANTIGO |
| State | WI |
| Zip Code | 54409-2475 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114000213 | Nicole Suzanne Debroux | Chiropractor | 2006 Progress Blvd, Antigo, WI 54409 | 2006-10-23 |
| 1891300836 | Erin L Desjarlais | Massage Therapist | 2006 Progress Blvd, Antigo, WI 54409-2475 | 2020-09-15 |
| 1841537701 | Cornerstone Chiropractic & Wellness LLC | Chiropractor | 2006 Progress Blvd, Antigo, WI 54409-2475 | 2013-01-12 |
| 1215209283 | Nicholas R Wachtel | Chiropractor | 2006 Progress Blvd, Antigo, WI 54409-2475 | 2012-02-06 |
| 1518265651 | Katherine Anne Kirwan | Chiropractor | 2006 Progress Blvd, Antigo, WI 54409-2475 | 2011-03-13 |
| 1053595777 | Angela Renee Thiele | Chiropractor | 2006 Progress Blvd, Antigo, WI 54409-2475 | 2007-12-18 |
| 1669678603 | Amy Stuber | Chiropractor | 2006 Progress Blvd, Antigo, WI 54409-2475 | 2007-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454036 | Jason Peter Cueny | Pharmacist | 200 E Highway 64, Antigo, WI 54409 | 2020-10-15 |
| 1770194524 | Christpher George Rowe | Technician | 825 Clermont S Apt 7, Antigo, WI 54409 | 2020-08-14 |
| 1033753512 | Joseph Gerger | Technician | 711 Badger Ave, Antigo, WI 54409 | 2019-10-29 |
| 1225368780 | Integrated Pain Solutions LLC | Clinic/Center | 2327 Neva Road, Antigo, WI 54409 | 2010-01-06 |
| 1558525212 | Jessica E Rosenberg | Social Worker | 310 South Superior Street, Antigo, WI 54409 | 2008-07-11 |
| 1053433292 | Raymond J Portman | Dentist | 705 Fifth Ave, Antigo, WI 54409 | 2007-04-06 |
| 1699801316 | Rick L Perkins | Obstetrics & Gynecology | Aspirus General Clinic, 110 East 5th Avenue, Antigo, WI 54409 | 2007-02-26 |
| 1205999646 | Earl J Roth | Chiropractor | 612 Century Ave, Antigo, WI 54409 | 2006-12-18 |
| 1811061187 | Rosanne Schermetzler | Occupational Therapist | 720 Ackley Street, Antigo, WI 54409 | 2006-11-20 |
| 1912084070 | Antigo Total Therapy & Sports Rehab Center Inc | Physical Therapist | 720 Askley Street, Antigo, WI 54409 | 2006-11-01 |
| Find all providers in zip 54409 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679606396 | Margaret Ann Rosauer-johnson | Chiropractor | 510 Superior St, Antigo, WI 54409-2043 | 2007-03-13 |
| 1225179112 | Andrew Cary Krueger | Chiropractor | 436 Superior St, Antigo, WI 54409-1855 | 2007-02-12 |
| 1912061987 | Elite Chiropractic Antigo Sc | Chiropractor | 239 Superior St, Antigo, WI 54409-1860 | 2006-12-21 |
| 1205999646 | Earl J Roth | Chiropractor | 612 Century Ave, Antigo, WI 54409 | 2006-12-18 |
| 1114000213 | Nicole Suzanne Debroux | Chiropractor | 2006 Progress Blvd, Antigo, WI 54409 | 2006-10-23 |
| 1154418390 | Integrated Pain Solutions LLC | Chiropractor | N2120 County Rd S, Antigo, WI 54409-8950 | 2006-10-09 |
| 1528164738 | Bruce C Goldsworthy | Chiropractor | 941 Century Ave, Antigo, WI 54409-2484 | 2006-09-15 |
| 1255435442 | Gerald N Rindal | Chiropractor | 1029 5th Ave, Antigo, WI 54409-1458 | 2006-09-11 |
| 1548379498 | Amanda Rae Diercks | Chiropractor | 1111 Langlade Rd, Antigo, WI 54409-2738 | 2006-08-30 |
| 1245262021 | Stacy M Bula | Chiropractor | 537 Field St, Antigo, WI 54409-2229 | 2006-07-06 |
| Find all providers in ANTIGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.