NPI | 1790895217 |
---|---|
Entity Type | Organization |
Authorized Contact | BRADLEY P DONNERMEYER Owner 920-734-2400 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 2798) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: WI 3834012) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2022-05-05 |