Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GLENN R WYSOCKI, DC
Active Sole ProprietorOrthopedic (Chiropractor) · KENOSHA, WI
Registration Details
- NPI Number
- 1215064597
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 27, 2007 (19.147798037144 yrs)
- Last Updated
- Dec 9, 2011
- Licenses
-
1512 (WI)1512 (WI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
7537 22ND AVENUEKENOSHA, WI, 531435701Browse WI providers · Browse ZIP 53143
- Phone
- 2626523100
- Fax
- 2626523100
- Primary Specialty
-
Orthopedic (Chiropractor)
111NX0800X
- Additional Specialty
- Orthopedic (Chiropractor)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.