National Provider Identifier Database

LAKE DELTON CHIROPRACTIC CLINIC LLC
Chiropractor

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.


Contact Information

LAKE DELTON CHIROPRACTIC CLINIC LLC
151 WISCONSIN DELLS PKWY S
WISCONSIN DELLS, WI53965
Phone: 608-253-0102
Fax: 608-253-0188
Website:
Specialty Taxonomy Code
* Chiropractor 111N00000X

* Indicates primary specialty

NPI Profile & details for LAKE DELTON CHIROPRACTIC CLINIC LLC

NPI Number 1619087871
Legal business name
LBN
LAKE DELTON CHIROPRACTIC CLINIC LLC
Authorized official TODD BAUER - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 08/30/2006
Last updated 05/17/2019 - About 7 years ago
Sole proprietor1 Not specified
Identifiers
  • WI License #: 4029-012
  • WI Medicaid: 39000300

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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