Provider Demographics
NPI:1811469869
Name:BAUTCH, ALEXIS JUNE (DC)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:JUNE
Last Name:BAUTCH
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 1:3540 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-4919
Mailing Address - Country:US
Mailing Address - Phone:715-842-3999
Mailing Address - Fax:715-843-7761
Practice Address - Street 1:1015 N 6TH ST
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54403-4761
Practice Address - Country:US
Practice Address - Phone:715-842-3999
Practice Address - Fax:715-843-7761
Is Sole Proprietor?:No
Enumeration Date:2018-12-31
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI542612111N00000X
WI5426111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor