Provider Demographics
NPI:1457841280
Name:BRUFLAT, LUCAS STEVEN (DC)
Entity Type:Individual
Prefix:
First Name:LUCAS
Middle Name:STEVEN
Last Name:BRUFLAT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18085 COUNTY HIGHWAY X
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-8741
Mailing Address - Country:US
Mailing Address - Phone:715-271-0444
Mailing Address - Fax:
Practice Address - Street 1:3277 COUNTY HIGHWAY P
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-5525
Practice Address - Country:US
Practice Address - Phone:715-271-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-17
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5351-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor