Provider Demographics
NPI:1558458026
Name:RUSSELL R HAUSER DC LLC
Entity Type:Organization
Organization Name:RUSSELL R HAUSER DC LLC
Other - Org Name:HASUER CHIRO-HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:R
Authorized Official - Last Name:HAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-538-1628
Mailing Address - Street 1:N72 W28550 SUSSEX ROAD
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029
Mailing Address - Country:US
Mailing Address - Phone:262-538-1628
Mailing Address - Fax:262-538-1630
Practice Address - Street 1:N72 W28550 SUSSEX ROAD
Practice Address - Street 2:
Practice Address - City:MERTON
Practice Address - State:WI
Practice Address - Zip Code:53056
Practice Address - Country:US
Practice Address - Phone:262-538-1628
Practice Address - Fax:262-538-1630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2171111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1891809422OtherNPI
1891809422OtherNPI