Gonzalez Family Chiropractic LLC.
Organization Active NPI Chiropractor · Woodruff, WI
NPI 1295181774 · NPPES record last updated May 13, 2016
Key facts
- NPI
- 1295181774
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 3390-12 (WI)
- Legal business name
- GONZALEZ FAMILY CHIROPRACTIC LLC.
- Practice address
- 1105 4TH Avenue
Woodruff, WI 54568-2061 - Phone
- (715) 356-1606
- Fax
- (715) 356-2170
- NPI assigned
- May 13, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Guillermo Eduardo Gonzalez, D.C.
- Title
- Member/Owner
- Phone
- (715) 356-1606
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 3390-12 | WI | Yes |
| Nutrition Chiropractor |
111NN1001X | 3390-12 | WI |
Addresses
Primary practice location
1105 4TH Avenue
Woodruff, WI 54568-2061
Mailing address
1105 4TH Avenue
PO Box 2061
Woodruff, WI 54568-2061
Phone (715) 356-1606
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38901900 | Medicaid | WI |
Other providers in Woodruff, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.