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NPI Code Detail

MEDICARE: BAUER CHIROPRACTIC, LLC

MEDICARE: BAUER CHIROPRACTIC, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor3462WI

General Provider Information

NPI Number : 1861421604
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAUER CHIROPRACTIC, LLC
Provider Business Mailing Address
First Line : 355 N. PETERS AVE.
Second Line : PO BOX 1898
City : FOND DU LAC
State : WI
Zip : 54935
Country : US
Telephone Number : 920-923-3322
Fax Number : 920-923-3322
Provider Business Practice Location Address
First Line : 355 N PETERS AVE
Second Line :
City : FOND DU LAC
State : WI
Zip : 54935-8258
Country : US
Telephone Number : 920-923-3322
Fax Number : 920-923-3322
Authorized Official
Title or Position : OWNER
Name : DR. SHAYNE MICHAEL BAUER
Credential : DC
Telephone Number : 920-923-3322
Provider Enumeration Date : 07/02/2006
Last Update Date : 04/30/2009

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Directions to “BAUER CHIROPRACTIC, LLC ” Practice Location

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