Provider Demographics
NPI:1699845271
Name:KAISER, CHRISTOPHER A (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:A
Last Name:KAISER
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 1:790 GARDNER ST
Mailing Address - Street 2:
Mailing Address - City:LAKE GENEVA
Mailing Address - State:WI
Mailing Address - Zip Code:53147-1233
Mailing Address - Country:US
Mailing Address - Phone:262-248-4001
Mailing Address - Fax:262-248-4069
Practice Address - Street 1:790 GARDNER ST
Practice Address - Street 2:
Practice Address - City:LAKE GENEVA
Practice Address - State:WI
Practice Address - Zip Code:53147-1233
Practice Address - Country:US
Practice Address - Phone:262-248-4001
Practice Address - Fax:262-248-4069
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3050012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000035339Medicare ID - Type Unspecified
U52560Medicare UPIN