Individual
DR. MARY J GONSTEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
431 E CLAIREMONT AVE, EAU CLAIRE, WI 54701-3685
(715) 832-2223
(715) 832-7416
Mailing address
503 E CLAIREMONT AVE, EAU CLAIRE, WI 54701-6479
(715) 832-2223
(715) 832-7416
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2063-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350010622
RAILROAD MEDICARE
WI
01
—
391744596019
BLUE CROSS
WI
Enumeration date
07/26/2005
Last updated
10/09/2018
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