Provider Demographics
NPI:1790854123
Name:HOUGEN, CHRIS HENRY (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:HENRY
Last Name:HOUGEN
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 1:4606 COMMERCE VALLEY RD
Mailing Address - Street 2:STE 209
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-7075
Mailing Address - Country:US
Mailing Address - Phone:715-832-6616
Mailing Address - Fax:
Practice Address - Street 1:4606 COMMERCE VALLEY RD
Practice Address - Street 2:STE 209
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-7075
Practice Address - Country:US
Practice Address - Phone:715-832-6616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1754111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38776100Medicaid
WI175541Medicare PIN
39-1975183Medicare UPIN