Provider Demographics
NPI:1174670251
Name:MICHAEL R TRAUB D.C. LTD
Entity Type:Organization
Organization Name:MICHAEL R TRAUB D.C. LTD
Other - Org Name:TRAUB CHIROPRACTIC CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUNK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-567-4497
Mailing Address - Street 1:N58W39799 HWY 16
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-2194
Mailing Address - Country:US
Mailing Address - Phone:262-567-4497
Mailing Address - Fax:262-567-3716
Practice Address - Street 1:N58W39799 W HWY 16
Practice Address - Street 2:
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066
Practice Address - Country:US
Practice Address - Phone:262-567-4497
Practice Address - Fax:262-567-3716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1385111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38750800Medicaid
WIT63531Medicare UPIN