Healthcare Provider Details

I. General information

NPI: 1992827554
Provider Name (Legal Business Name): CHIROPRACTIC COMPANY - CEDARBURG LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W57N14280 DOERR WAY STE 101
CEDARBURG WI
53012-3108
US

IV. Provider business mailing address

W57N14280 DOERR WAY STE 101
CEDARBURG WI
53012-3108
US

V. Phone/Fax

Practice location:
  • Phone: 262-377-3240
  • Fax: 262-421-2773
Mailing address:
  • Phone: 262-377-3240
  • Fax: 262-421-2773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN P CORSI
Title or Position: CFO
Credential: DC
Phone: 414-354-5377