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Contact Information

BLAU CHIROPRACTIC SC
641 LATTON LN
PORTAGE, WI53901-1078
 Phone: 608-742-1300
 Fax: 608-745-0147
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Chiropractor

111N00000X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for BLAU CHIROPRACTIC SC

NPI # 1003003716
LBN Legal business name BLAU CHIROPRACTIC SC
Authorized official KEVIN BLAU - (CHIROPRACTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 09/26/2007
Last updated 11/13/2012 - About 14 years ago
Identifiers
WI License # 2990
WI Medicaid 38887700
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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