Provider Demographics
NPI:1962989517
Name:GINTNER, DREW DAVID (DC)
Entity type:Individual
Prefix:
First Name:DREW
Middle Name:DAVID
Last Name:GINTNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2829 COUNTY HIGHWAY I # 3C
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-2652
Mailing Address - Country:US
Mailing Address - Phone:470-334-4191
Mailing Address - Fax:715-532-6547
Practice Address - Street 1:2829 COUNTY HIGHWAY I # 3C
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-2652
Practice Address - Country:US
Practice Address - Phone:470-334-4191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5366-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor