Doctorleo LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3847-012 Issued in WI

Legal business name

DOCTORLEO LLC

Practice address

227 Meridian Dr
Ste 4
New Richmond, WI 54017-2565

Phone

(612) 963-2248

Fax

(715) 997-3019

NPI assigned

Dec 14, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Leo Raymond Gonsowski III, D.C

Title

Owner

Phone

(612) 963-2248

Specialties & licenses 1

Addresses

Other names 1

• TheChiropractor Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1481673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514937600000",
    "number": "1326582008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 160TH ST",
            "city": "HAMMOND",
            "state": "WI",
            "postal_code": "540155011",
            "telephone_number": "612-963-2248",
            "fax_number": "715-997-3019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 MERIDIAN DR",
            "address_2": "STE 4",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "540172565",
            "telephone_number": "612-963-2248",
            "fax_number": "715-997-3019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORLEO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-14",
        "last_updated": "2018-01-03",
        "status": "A",
        "authorized_official_last_name": "GONSOWSKI",
        "authorized_official_first_name": "LEO",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-963-2248",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3847-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TheChiropractor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Joseph A Dietzler, MD
• Wendy J Dixen-Dadez, PT
• Jennifer Dombovy, LICSW
• Lisa Anne Dorenbush, OTR/L
• Alexandra Josephine Dorn, MS, LPC
• Benjamin Ward Dummer, MD
• Melissa Jean Dyshaw, D.P.T.

• All providers in New Richmond, WI
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.