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
Fax: (262) 248-6393
Website:

Health care specialties

SpecialtyCodeLicense #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 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881624823 NPPES
Wisconsin MEDICAID 38863200

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