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General NPI Number Information
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NPI Number | 1457841280
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Entity Type | Individual
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Provider Name | LUCAS STEVEN BRUFLAT DC
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Gender | Male
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Dates
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Enumeration Date | 05/17/2018
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Last Update Date | 01/14/2020
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Provider Practice Location Address
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Address Line | 3277 COUNTY HIGHWAY P
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City | CHIPPEWA FALLS
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State | WI
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Zip | 54729-5525
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Country | US
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Telephone | 715-271-0444
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Fax |
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Provider Business Mailing Address
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Address Line | 18085 COUNTY HIGHWAY X
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City | CHIPPEWA FALLS
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State | WI
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Zip | 54729-8741
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Country | US
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Telephone | 715-271-0444
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5351-12
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License Number State | WI
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