Provider Demographics
NPI:1154694313
Name:DAWSON, KATELYN ANN (DC)
Entity type:Individual
Prefix:DR
First Name:KATELYN
Middle Name:ANN
Last Name:DAWSON
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:N35W23770 CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-6312
Mailing Address - Country:US
Mailing Address - Phone:262-695-1870
Mailing Address - Fax:
Practice Address - Street 1:N35W23770 CAPITOL DR
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-6312
Practice Address - Country:US
Practice Address - Phone:262-695-1870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-20
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4847-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor