Individual
DR. JEFFREY GENE BUNTROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
612 S WELLS ST, SUITE C, LAKE GENEVA, WI 53147-2159
(262) 248-8177
(262) 248-6393
Mailing address
612 S WELLS ST, SUITE C, LAKE GENEVA, WI 53147-2159
(262) 248-8177
(262) 248-6393
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2834-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38863200
—
WI
Enumeration date
07/04/2006
Last updated
05/29/2013
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