Organization
INTEGRATED HEALTH OF MILWAUKEE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY BONIKOWSKE D.C. (OWNER)
(414) 837-4468
Entity
Organization
Contact information
Practice address
2323 N MAYFAIR RD, SUITE 104, WAUWATOSA, WI 53226-1506
(414) 837-4468
(414) 837-4212
Mailing address
2323 N MAYFAIR RD, SUITE 104, WAUWATOSA, WI 53226-1506
(414) 837-4468
(414) 837-4212
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
4606-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700116233
—
WI
Enumeration date
07/08/2015
Last updated
08/10/2015
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