Provider Demographics
NPI:1467757666
Name:CHIROPRACTIC COMPANY - GREENFIELD LTD
Entity Type:Organization
Organization Name:CHIROPRACTIC COMPANY - GREENFIELD LTD
Other - Org Name:CHIROPRACTIC COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:CORSI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:414-354-5377
Mailing Address - Street 1:4818 S. 76TH STREET
Mailing Address - Street 2:SUITE 12
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-4223
Mailing Address - Country:US
Mailing Address - Phone:414-321-2273
Mailing Address - Fax:414-321-5552
Practice Address - Street 1:4818 S 76TH ST STE 12
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-4362
Practice Address - Country:US
Practice Address - Phone:414-321-2273
Practice Address - Fax:414-271-1727
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHIROPRACTIC COMPANY, S.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-19
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2547111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty