Individual
JEREMY GONSOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1750 HIGHWAY 192 W, SUITE 4, LONDON, KY 40741-2639
(606) 878-0088
Mailing address
PO BOX 593, BEREA, KY 40403-0593
(606) 878-0088
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5397
KY
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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