Individual
TARA MARIE GILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
N35W23770 CAPITOL DR, PEWAUKEE, WI 53072-6312
(262) 695-1870
(262) 695-1872
Mailing address
N35W23770 CAPITOL DR, PEWAUKEE, WI 53072-6312
(262) 695-1870
(262) 695-1872
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4098
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38961000
—
WI
Enumeration date
12/06/2006
Last updated
07/08/2007
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