Provider Demographics
NPI:1689722316
Name:SCHAFFER, NYHUS (DC)
Entity Type:Individual
Prefix:DR
First Name:NYHUS
Middle Name:
Last Name:SCHAFFER
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 1:402 6TH ST S
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-4505
Mailing Address - Country:US
Mailing Address - Phone:608-785-2225
Mailing Address - Fax:608-782-2947
Practice Address - Street 1:402 6TH ST S
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-4505
Practice Address - Country:US
Practice Address - Phone:608-785-2225
Practice Address - Fax:608-782-2947
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4116-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI201803762015OtherBLUE SHIELD ID NUMBER
WI38959300Medicaid
WI000135714Medicare ID - Type Unspecified
WIV04097Medicare UPIN