MEDICARE: JOEL J GARTNER DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2538-012	WI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	CJ7410	OTHER		RAILROAD MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	31818	OTHER	SECURITY HEALTH PLAN

General Provider Information

NPI Number	:	1477659670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEL J GARTNER DC

Provider Business Mailing Address
First Line	:	601 S 32ND AVE
Second Line	:
City	:	WAUSAU
State	:	WI
Zip	:	54401-3958
Country	:	US
Telephone Number	:	715-848-2526
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 E MAIN ST
Second Line	:
City	:	BLACK RIVER FALLS
State	:	WI
Zip	:	54615-1408
Country	:	US
Telephone Number	:	715-284-5550
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	12/14/2007

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Directions to “ JOEL J GARTNER DC” Practice Location

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