Provider Demographics
NPI:1790862514
Name:KAISER, LISA BELINDA (DC)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:BELINDA
Last Name:KAISER
Suffix:
Gender:F
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:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD CITY
Mailing Address - State:WI
Mailing Address - Zip Code:54013-0219
Mailing Address - Country:US
Mailing Address - Phone:715-265-7267
Mailing Address - Fax:715-265-7977
Practice Address - Street 1:144 EAST OAK STREET
Practice Address - Street 2:
Practice Address - City:GLENWOOD CITY
Practice Address - State:WI
Practice Address - Zip Code:54013
Practice Address - Country:US
Practice Address - Phone:715-265-7267
Practice Address - Fax:715-265-7997
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2311111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38835000Medicaid
WV116M4KAOtherBCBS OF MINNESOTA
WI11476396Medicare UPIN
WV116M4KAOtherBCBS OF MINNESOTA