Provider Demographics
NPI:1992833776
Name:LAUER FAMILY CHIROPRACTIC INC
Entity Type:Organization
Organization Name:LAUER FAMILY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:LAUER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-446-0220
Mailing Address - Street 1:821 MEADOWBROOK RD STE 4
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-7314
Mailing Address - Country:US
Mailing Address - Phone:262-446-0220
Mailing Address - Fax:262-446-0219
Practice Address - Street 1:821 MEADOWBROOK RD STE 4
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-7314
Practice Address - Country:US
Practice Address - Phone:262-446-0220
Practice Address - Fax:262-446-0219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3580012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI68774Medicare ID - Type UnspecifiedDR. MEDICARE NUMBER