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Individual

DR. THOMAS F BURLAGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
801 N MAIN ST, SUITE I, LODI, WI 53555-1279
(608) 592-1444
(608) 592-1445
Mailing address
801 N MAIN ST, SUITE I, LODI, WI 53555-1279
(608) 592-1444
(608) 592-1445

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3522
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3522
LICENSE
WI
05
38930100
WI
01
392029630016
BCBS
WI
Enumeration date
11/20/2006
Last updated
10/03/2014
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