Organization
DOCTORLEO LLC
Active
Other names
TheChiropractor
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEO RAYMOND GONSOWSKI III D.C (OWNER)
(612) 963-2248
Entity
Organization
Contact information
Practice address
227 MERIDIAN DR, STE 4, NEW RICHMOND, WI 54017-2565
(612) 963-2248
(715) 997-3019
Mailing address
762 160TH ST, HAMMOND, WI 54015-5011
(612) 963-2248
(715) 997-3019
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3847-012
WI
Other
Enumeration date
12/14/2016
Last updated
01/03/2018
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