Individual
DR. NICHOLE N PANKOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
109 E MILWAUKEE ST, JEFFERSON, WI 53549-1635
(920) 674-6627
(920) 674-6632
Mailing address
855 HILLSIDE DR, JEFFERSON, WI 53549-1805
(920) 674-6627
(920) 674-6632
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4014-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38955900
—
WI
Enumeration date
06/22/2006
Last updated
07/09/2007
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