Provider Demographics
NPI:1750486338
Name:GURSKE, DONN THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:DONN
Middle Name:THOMAS
Last Name:GURSKE
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 1:9217 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-4516
Mailing Address - Country:US
Mailing Address - Phone:414-771-1968
Mailing Address - Fax:414-771-3465
Practice Address - Street 1:9217 W CENTER ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-4516
Practice Address - Country:US
Practice Address - Phone:414-771-1968
Practice Address - Fax:414-771-3465
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2246-012111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38868200Medicaid
T62084Medicare UPIN
WI38868200Medicaid