Healthcare Provider Details

I. General information

NPI: 1770611808
Provider Name (Legal Business Name): CHIROPRACTIC COMPANY - MENOMONEE FALLS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N96W18743 COUNTY LINE RD STOP E
MENOMONEE FALLS WI
53051-7100
US

IV. Provider business mailing address

N96W18743 COUNTY LINE RD STOP E
MENOMONEE FALLS WI
53051-7100
US

V. Phone/Fax

Practice location:
  • Phone: 262-253-6779
  • Fax: 262-257-9502
Mailing address:
  • Phone: 262-253-6779
  • Fax: 262-257-9502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN PAUL CORSI
Title or Position: CFO
Credential: DC
Phone: 262-253-6779