Provider Demographics
NPI:1992780027
Name:HUNTER, GARLAND LEE (DOCTOR OF CHIROPRACT)
Entity type:Individual
Prefix:
First Name:GARLAND
Middle Name:LEE
Last Name:HUNTER
Suffix:
Gender:M
Credentials:DOCTOR OF CHIROPRACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 224
Mailing Address - Street 2:
Mailing Address - City:LAONA
Mailing Address - State:WI
Mailing Address - Zip Code:54541
Mailing Address - Country:US
Mailing Address - Phone:715-674-5334
Mailing Address - Fax:
Practice Address - Street 1:4925 HWY 8 & 32
Practice Address - Street 2:
Practice Address - City:LAONA
Practice Address - State:WI
Practice Address - Zip Code:54541
Practice Address - Country:US
Practice Address - Phone:715-674-5334
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2781111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38925800Medicaid
33188Medicare UPIN
WI38925800Medicaid