Organization
ST NICHOLAS HEALTH INSTITUTE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOB GOUNTIS D.C. (PRESIDENT)
(414) 778-1455
Entity
Organization
Contact information
Practice address
1033 N MAYFAIR RD, SUITE 303, WAUWATOSA, WI 53226-3442
(414) 778-1455
(414) 810-4052
Mailing address
1033 N MAYFAIR RD, SUITE 303, WAUWATOSA, WI 53226-3442
(414) 778-1455
(414) 778-1865
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
3517-012
WI
Other
Enumeration date
02/16/2009
Last updated
09/02/2010
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