Individual
CLIFFORD JONAS GIDLUND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
344 PARK AVE, PEWAUKEE, WI 53072-3414
(715) 298-0267
Mailing address
344 PARK AVE, PEWAUKEE, WI 53072-3414
(715) 298-0267
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
710-55
WI
Other
Enumeration date
03/01/2019
Last updated
03/01/2019
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