Provider Demographics
NPI:1912330903
Name:BUBNICH, ADAM J (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:J
Last Name:BUBNICH
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:601 N SUPERIOR AVE
Mailing Address - Street 2:STE 6
Mailing Address - City:TOMAH
Mailing Address - State:WI
Mailing Address - Zip Code:54660-1589
Mailing Address - Country:US
Mailing Address - Phone:608-372-9686
Mailing Address - Fax:608-372-9688
Practice Address - Street 1:601 N SUPERIOR AVE
Practice Address - Street 2:STE 6
Practice Address - City:TOMAH
Practice Address - State:WI
Practice Address - Zip Code:54660-1589
Practice Address - Country:US
Practice Address - Phone:608-372-9686
Practice Address - Fax:608-372-9688
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2014-02-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI4970-12111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor