Blau, Kevin A.

Blau, Kevin A. is an individual health care provider with primary practice located at 641 Latton Ln Suite A, Portage WI 53901-1078. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Blau, Kevin A. can be contacted via phone (608) 742-1300.

Contact Information

Primary practice address
641 Latton Ln Suite A Portage WI 53901-1078
Phone: (608) 742-1300
Fax: (608) 745-0147
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 2990 Wisconsin

Profile Details

NPI number 1932194172
LBN Legal business name Blau, Kevin A.
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2005
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932194172 NPPES
Wisconsin MEDICAID 38887700

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