Provider Demographics
NPI:1477614527
Name:HELGOE, GORDON JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:GORDON
Middle Name:JOHN
Last Name:HELGOE
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:E9225 HWY 85
Mailing Address - Street 2:
Mailing Address - City:MONDOVI
Mailing Address - State:WI
Mailing Address - Zip Code:54755-0021
Mailing Address - Country:US
Mailing Address - Phone:715-875-4900
Mailing Address - Fax:715-875-4901
Practice Address - Street 1:E9225 HWY 85
Practice Address - Street 2:
Practice Address - City:MONDOVI
Practice Address - State:WI
Practice Address - Zip Code:54755-0021
Practice Address - Country:US
Practice Address - Phone:715-875-4900
Practice Address - Fax:715-875-4901
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1987111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38934500Medicaid
WI38934500Medicaid