Individual
GREGORY L BONIKOWSKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2323 N MAYFAIR RD, SUITE 104, WAUWATOSA, WI 53226-1506
(414) 837-4468
(414) 837-4212
Mailing address
2323 N MAYFAIR RD, SUITE 104, WAUWATOSA, WI 53226-1506
(414) 837-4468
(414) 837-4212
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4606-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4606-012
WI DEPARTMENT OF REGULATION AND LICENSING
WI
Enumeration date
01/06/2010
Last updated
05/19/2015
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