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Individual

LEO J BRONSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
1202 COUNTY RD PH, SUITE 100, ONALASKA, WI 54650
(608) 781-2225
(608) 781-6425
Mailing address
PO BOX 783, ONALASKA, WI 54650-0783
(608) 781-2225
(608) 781-6425

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1491-012
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
350022982
RAILROAD MEDICARE
WI
05
38766900
WI
Enumeration date
07/18/2006
Last updated
11/28/2011
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