Blodgett, Charles Donald

Blodgett, Charles Donald is an individual health care provider with primary practice located at 10025 W Greenfield Ave , West Allis WI 53214-3956. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Blodgett, Charles Donald can be contacted via phone (414) 292-3499.

Contact Information

Primary practice address
10025 W Greenfield Ave West Allis WI 53214-3956
Phone: (414) 292-3499
Fax: (414) 292-3494
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 3292-012 Wisconsin

Profile Details

NPI number 1649371030
LBN Legal business name Blodgett, Charles Donald
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2006
Last updated Feb 15th, 2020 - about 5 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 1649371030 NPPES
Wisconsin MEDICAID 38892300

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