Organization
GILL FAMILY CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA MARIE GILL DC (CHIROPRACTOR)
(262) 725-7325
Entity
Organization
Contact information
Practice address
104 E WALWORTH AVE, SUITE 102, DELAVAN, WI 53115-1146
(262) 725-7325
(888) 556-3358
Mailing address
104 E WALWORTH AVE, SUITE 102, DELAVAN, WI 53115-1146
(262) 725-7325
(888) 556-3358
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1048012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38961000
—
WI
Enumeration date
01/06/2010
Last updated
06/09/2010
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