Provider Demographics
NPI:1558423079
Name:VEALE CHIROPRACTIC OFFICE
Entity Type:Organization
Organization Name:VEALE CHIROPRACTIC OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:VEALE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-473-7274
Mailing Address - Street 1:543 S PUTNAM ST
Mailing Address - Street 2:
Mailing Address - City:WHITEWATER
Mailing Address - State:WI
Mailing Address - Zip Code:53190
Mailing Address - Country:US
Mailing Address - Phone:262-473-7274
Mailing Address - Fax:262-473-4501
Practice Address - Street 1:543 S PUTNAM ST
Practice Address - Street 2:
Practice Address - City:WHITEWATER
Practice Address - State:WI
Practice Address - Zip Code:53190
Practice Address - Country:US
Practice Address - Phone:262-473-7274
Practice Address - Fax:262-473-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1558012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI5484790001Medicare NSC
WIT63570Medicare UPIN
WI000075621Medicare PIN