Individual
DR. KEVIN A. BLAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
641 LATTON LN, SUITE A, PORTAGE, WI 53901-1078
(608) 742-1300
(608) 745-0147
Mailing address
641 LATTON LN, SUITE A, 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
09/14/2005
Last updated
07/09/2007
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