Nystrom, Gregory J
Nystrom, Gregory J is an individual health care provider with primary practice located at 1441 Bellevue St Bellevue Chiropractic Clinic, Green Bay WI 54311-5605. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Nystrom, Gregory J can be contacted via phone (920) 465-7772.Contact Information
Primary practice address
1441 Bellevue St Bellevue Chiropractic Clinic
Green Bay WI 54311-5605
Phone: (920) 465-7772
Fax: (920) 468-9785
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 3062 | Wisconsin |
Profile Details
| NPI number | 1871572321 |
|---|---|
| LBN Legal business name | Nystrom, Gregory J |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 12th, 2006 |
| Last updated | Nov 23rd, 2021 - about 5 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 | 1871572321 | NPPES |
| Wisconsin | MEDICAID | 3889700 |
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