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General NPI Number Information
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NPI Number | 1952647802
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC COMPANY - THIRD WARD LTD
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Dates
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Enumeration Date | 12/21/2012
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Last Update Date | 12/19/2019
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Provider Practice Location Address
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Address Line | 140 S 1ST ST STE 101
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City | MILWAUKEE
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State | WI
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Zip | 53204-4317
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Country | US
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Telephone | 414-271-1717
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Fax | 414-271-1727
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Provider Business Mailing Address
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Address Line | 140 S 1ST ST STE 101
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City | MILWAUKEE
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State | WI
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Zip | 53204-4317
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Country | US
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Telephone | 414-271-1717
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Fax | 414-271-1727
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Authorized Official
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Title or Position | PARTNER
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Name | DR. JOHN CORSI
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Credential | DC
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Telephone | 414-354-5377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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