Organization
LAKE DELTON CHIROPRACTIC CLINIC LLC
Active
Other names
HealthSource Chiropractic & Progressive Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD JOSEPH BAUER D.C. (OWNER)
(608) 697-9994
Entity
Organization
Contact information
Practice address
151 WISCONSIN DELLS PKWY S, WISCONSIN DELLS, WI 53965
(608) 253-0102
(608) 253-0188
Mailing address
151 WISCONSIN DELLS PKWY S, WISCONSIN DELLS, WI 53965
(608) 253-0102
(608) 253-0188
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4029-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39000300
—
WI
Enumeration date
08/30/2006
Last updated
05/17/2019
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