BLAU CHIROPRACTIC SC NPI 1003003716

NPI Information

NPI: 1003003716
Provider Name: BLAU CHIROPRACTIC SC
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
641 LATTON LN
PORTAGE, WI
ZIP 53901
Phone: (608) 742-1300
Get Directions

BLAU CHIROPRACTIC SC is a chiropractor in Portage, WI. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. BLAU CHIROPRACTIC SC NPI is 1003003716. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

641 LATTON LN
PORTAGE, WI
ZIP 53901-078
Phone: (608) 742-1300
Fax: (608) 745-0147

The provider's authorized official is Kevin A Blau .
The authorized official title is Chiropractor and has the following contact phone number (608) 742-1300.

The enumeration date for this NPI number is 9/26/2007 and was last updated on 11/13/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111N00000X	Chiropractor		2990	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	38887700	MEDICAID	WISCONSIN
2	000075332	MEDICARE PIN	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 9/11/2023

NPI Synchronization or Removal

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