Provider Demographics
NPI:1417676875
Name:LABUS, BRIDGET GRACE (DC)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:GRACE
Last Name:LABUS
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 1:203 PRAIRIE DR
Mailing Address - Street 2:
Mailing Address - City:WALWORTH
Mailing Address - State:WI
Mailing Address - Zip Code:53184-9795
Mailing Address - Country:US
Mailing Address - Phone:415-710-4708
Mailing Address - Fax:
Practice Address - Street 1:203 PRAIRIE DR
Practice Address - Street 2:
Practice Address - City:WALWORTH
Practice Address - State:WI
Practice Address - Zip Code:53184-9795
Practice Address - Country:US
Practice Address - Phone:415-710-4708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6302-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor