Individual
ANDREA M KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
610 SOUTH ST, GREEN LAKE, WI 54941-9496
(920) 229-7215
Mailing address
PO BOX 163, GREEN LAKE, WI 54941-0163
(920) 229-7215
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4457-012
WI
Other
Enumeration date
02/27/2009
Last updated
02/27/2009
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