Organization
BLAU CHIROPRACTIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN A BLAU DC (CHIROPRACTOR)
(608) 742-1300
Entity
Organization
Contact information
Practice address
641 LATTON LN, PORTAGE, WI 53901-1078
(608) 742-1300
(608) 745-0147
Mailing address
641 LATTON LN, PORTAGE, WI 53901-1078
(608) 742-1300
(608) 745-0147
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2990
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38887700
—
WI
Enumeration date
09/26/2007
Last updated
11/13/2012
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