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NPI Code Detail

MEDICARE: DR. GREGORY WINTON BERNARD D.C.

MEDICARE:  DR. GREGORY WINTON BERNARD  D.C.
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
1111N00000XChiropractor3147MN
2111N00000XChiropractor3021WI

General Provider Information

NPI Number : 1578509790
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY WINTON BERNARD D.C.
Provider Business Mailing Address
First Line : 511 PRAIRIE LN
Second Line :
City : HUDSON
State : WI
Zip : 54016-7037
Country : US
Telephone Number : 715-410-0706
Fax Number : 715-410-0706
Provider Business Practice Location Address
First Line : 330 WEST MAIN STREET
Second Line :
City : ELLSWORTH
State : WI
Zip : 54011-5087
Country : US
Telephone Number : 715-410-0706
Fax Number : 715-410-0706
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 05/06/2015

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