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General NPI Number Information
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NPI Number | 1780748327
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Entity Type | Individual
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Provider Name | MARC A GILEROVICH DC
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Gender | Male
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | W164 N11297 SQUIRE DRIVE
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City | GERMANTOWN
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State | WI
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Zip | 53022
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Country | US
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Telephone | 262-250-1948
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Fax | 262-250-1004
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Provider Business Mailing Address
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Address Line | 985 W OKLAHOMA AVENUE
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City | MILWAUKEE
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State | WI
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Zip | 53215-4749
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Country | US
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Telephone | 414-481-1021
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Fax | 414-481-3044
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3602012
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License Number State | WI
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