Organization
GUNDLACH CHIROPRACTIC, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER OSCAR GUNDLACH D.C. (PRESIDENT)
(920) 745-3020
Entity
Organization
Contact information
Practice address
315 MOUNT ZION DR, RIPON, WI 54971-1713
(920) 745-3020
Mailing address
315 MOUNT ZION DR, RIPON, WI 54971-1713
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2307-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38842600
—
WI
Enumeration date
10/19/2011
Last updated
10/19/2011
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