Individual
DR. LEO RAYMOND GONSOWSKI III
Active
Individual
DR. LEO RAYMOND GONSOWSKI III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC, CSCS
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
3847-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2C933GO
BLUE CROSS & BLUE SHIELD
MN
01
—
666234
CHIROCARE WISCONSIN
WI
Enumeration date
10/11/2005
Last updated
07/13/2026
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