Provider Demographics
NPI:1750582185
Name:HAASE CHIROPRACTIC CARE INC
Entity type:Organization
Organization Name:HAASE CHIROPRACTIC CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAASE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:608-231-3900
Mailing Address - Street 1:4200 UNIVERSITY AVE
Mailing Address - Street 2:2100
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-2100
Mailing Address - Country:US
Mailing Address - Phone:608-231-3900
Mailing Address - Fax:608-231-6800
Practice Address - Street 1:4200 UNIVERSITY AVE
Practice Address - Street 2:2100
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-2100
Practice Address - Country:US
Practice Address - Phone:608-231-3900
Practice Address - Fax:608-231-6800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1647111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38767600Medicaid
WI412173481012OtherBLUECROSS BLUE SHIELD
WI412173481012OtherBLUECROSS BLUE SHIELD
WI38767600Medicaid