Individual
DR. NICHOLAS JAY LUNDBOHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
N56W15560 SILVER SPRING DR STE E, MENOMONEE FALLS, WI 53051-6148
(877) 442-4476
Mailing address
N56W15560 SILVER SPRING DR STE E, MENOMONEE FALLS, WI 53051-6148
(877) 442-4476
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4323-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
609K9LU
BLUE CROSS BLUE SHIELD
MN
05
—
842929400
—
MN
Enumeration date
02/02/2007
Last updated
05/13/2022
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