Individual
GREGORY NORDWIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
504 LAKELAND RD, SHAWANO, WI 54166-3836
(715) 524-6844
Mailing address
504 LAKELAND RD, SHAWANO, WI 54166-3836
(715) 524-6844
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
198322-30
WI
Other
Enumeration date
03/06/2019
Last updated
03/06/2019
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