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Organization

PONICK CHIROPRACTIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIM PONICK (OFFICE MANAGER)
(715) 644-5428
Entity
Organization

Contact information

Practice address
9520 COUNTY HIGHWAY H, STANLEY, WI 54768-6033
(715) 644-5428
(715) 644-5486
Mailing address
9520 COUNTY HIGHWAY H, STANLEY, WI 54768-6033
(715) 644-5428
(715) 644-5486

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
2802-12
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38861300
WI
Enumeration date
10/05/2011
Last updated
05/09/2012
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