MEDICARE: DREW DAVID GINTNER 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	5366-12	WI

General Provider Information

NPI Number	:	1962989517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DREW DAVID GINTNER DC

Provider Business Mailing Address
First Line	:	2829 COUNTY HIGHWAY I # 3C
Second Line	:
City	:	CHIPPEWA FALLS
State	:	WI
Zip	:	54729-2652
Country	:	US
Telephone Number	:	470-334-4191
Fax Number	:	715-532-6547

Provider Business Practice Location Address
First Line	:	2829 COUNTY HIGHWAY I # 3C
Second Line	:
City	:	CHIPPEWA FALLS
State	:	WI
Zip	:	54729-2652
Country	:	US
Telephone Number	:	470-334-4191
Fax Number	:

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

Provider Enumeration Date	:	07/26/2018
Last Update Date	:	05/13/2019

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