Healthcare Provider Details

I. General information

NPI: 1497901334
Provider Name (Legal Business Name): GURSKE CHIROPRACTIC OFFICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2008
Last Update Date: 09/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9217 W CENTER ST
MILWAUKEE WI
53222-4516
US

IV. Provider business mailing address

9217 W. CENTER ST
MILWAUKEE WI
53222
US

V. Phone/Fax

Practice location:
  • Phone: 414-771-1968
  • Fax: 414-771-3465
Mailing address:
  • Phone: 414-771-1968
  • Fax: 414-771-3465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2246012
License Number StateWI

VIII. Authorized Official

Name: DR. DONN T. GURSKE
Title or Position: PRESIDENT
Credential: D.C.
Phone: 414-771-1968