Individual
GARY GONNERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
405 SUMNER AVE, HUMBOLDT, IA 50548-1728
(515) 332-2755
Mailing address
405 SUMNER AVE, HUMBOLDT, IA 50548-1728
(515) 332-2755
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
04523
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0132266
—
IA
01
—
13226
BCBS
IA
Enumeration date
12/29/2005
Last updated
09/19/2012
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