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Organization
KETTLE MORAINE CHIROPRACTIC CLINIC SC
Active
Organization
KETTLE MORAINE CHIROPRACTIC CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT SCOTT GRONSKI DC (PRESIDENT)
(262) 334-1011
Entity
Organization
Contact information
Practice address
223 W PARADISE DR, WEST BEND, WI 53095-4903
(262) 334-1011
(262) 338-0306
Mailing address
223 W PARADISE DR, WEST BEND, WI 53095-4903
(262) 334-1011
(262) 338-0306
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2539012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38863700
—
WI
Enumeration date
12/08/2006
Last updated
04/24/2017
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