| NPI | 1902960511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE ALBERT WULF Owner 608-782-2943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 4102) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 4663) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2020-08-22 |