Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 3195-012 | WI |
NPI | 1003950379 |
---|---|
Provider Name | Dr. Tory J. Nordlinder |
First Address | Neenah, WI 54956-2254 |
Second Address | Neenah, WI 54956-2254 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
38886200 | (05) | WI |