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Individual

DR. LANCE ALBERT WULF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
215 N BLACK RIVER ST, SPARTA, WI 54656-1529
(608) 269-4511
(608) 269-8511
Mailing address
601 S 32ND AVE, WAUSAU, WI 54401-3958
(715) 848-2526
(715) 848-2225

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4102
WI
111N00000X
Chiropractor
4663
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051H2WU
BLUE CROSS BLUE SHEILD
MN
01
201803724
UNITED HEALTH CARE
WI
01
2018037247
WPS
WI
05
38958900
WI
01
5605960001
MEDICARE DMEPOS
WI
01
966462900
MCARE OF MINNESOTA
MN
Enumeration date
09/13/2006
Last updated
02/25/2011
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