Provider Demographics
NPI:1891954822
Name:BAUER, KURT EDWARD (DILP AC, MSOM)
Entity Type:Individual
Prefix:MR
First Name:KURT
Middle Name:EDWARD
Last Name:BAUER
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Gender:M
Credentials:DILP AC, MSOM
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Mailing Address - Street 1:285 FOREST GROVE DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-3782
Mailing Address - Country:US
Mailing Address - Phone:262-691-1746
Mailing Address - Fax:262-691-1862
Practice Address - Street 1:285 FOREST GROVE DR
Practice Address - Street 2:SUITE 208
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-3782
Practice Address - Country:US
Practice Address - Phone:262-691-1746
Practice Address - Fax:262-691-1862
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI548-055171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist