MEDICARE: PAPE CHIROPRACTIC CLINICS III

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2693	WI

General Provider Information

NPI Number	:	1215142328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAPE CHIROPRACTIC CLINICS III

Provider Business Mailing Address
First Line	:	4433 N OAKLAND AVE
Second Line	:
City	:	SHOREWOOD
State	:	WI
Zip	:	53211-1611
Country	:	US
Telephone Number	:	414-967-9000
Fax Number	:	414-967-9002

Provider Business Practice Location Address
First Line	:	4433 N OAKLAND AVE
Second Line	:
City	:	SHOREWOOD
State	:	WI
Zip	:	53211-1611
Country	:	US
Telephone Number	:	414-967-9000
Fax Number	:	414-967-9002

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRETT C PAPE
Credential	:	D.C.
Telephone Number	:	414-967-9000

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	08/22/2020

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