Healthcare Provider Details

I. General information

NPI: 1033750476
Provider Name (Legal Business Name): CHIROPRACTIC COMPANY - MILWAUKEE DOWNTOWN LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2019
Last Update Date: 10/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 E HIGHLAND AVE STE A
MILWAUKEE WI
53202-6605
US

IV. Provider business mailing address

11129 N WAUWATOSA RD
MEQUON WI
53097-3431
US

V. Phone/Fax

Practice location:
  • Phone: 414-220-9441
  • Fax:
Mailing address:
  • Phone: 414-354-5377
  • Fax:

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 PAUL CORSI
Title or Position: CFO
Credential: DC
Phone: 414-354-5377