Buntrock, Jeffrey Gene
Buntrock, Jeffrey Gene is an individual health care provider with primary practice located at 612 S Wells St Suite C, Lake Geneva WI 53147-2159. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Buntrock, Jeffrey Gene can be contacted via phone (262) 248-8177.Contact Information
Primary practice address
612 S Wells St Suite C
Lake Geneva WI 53147-2159
Phone: (262) 248-8177
Fax: (262) 248-6393
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 2834-012 | Wisconsin |
Profile Details
| NPI number | 1881624823 |
|---|---|
| LBN Legal business name | Buntrock, Jeffrey Gene |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 4th, 2006 |
| Last updated | May 29th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881624823 | NPPES |
| Wisconsin | MEDICAID | 38863200 |
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