Provider Demographics
NPI:1578103578
Name:CHIROPRACTIC COMPANY - MUSKEGO LLC
Entity Type:Organization
Organization Name:CHIROPRACTIC COMPANY - MUSKEGO LLC
Other - Org Name:CHIROPRACTIC COMPANY - MUSKEGO LTD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:DR
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:W189S7773 RACINE AVE
Mailing Address - Street 2:
Mailing Address - City:MUSKEGO
Mailing Address - State:WI
Mailing Address - Zip Code:53150-9546
Mailing Address - Country:US
Mailing Address - Phone:262-679-2060
Mailing Address - Fax:
Practice Address - Street 1:W189S7773 RACINE AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGO
Practice Address - State:WI
Practice Address - Zip Code:53150-9546
Practice Address - Country:US
Practice Address - Phone:262-679-2060
Practice Address - Fax:262-421-2773
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHIROPRACTIC COMPANY S.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty