Provider Demographics
NPI:1710613674
Name:MICHAEL GIESIE LLC
Entity Type:Organization
Organization Name:MICHAEL GIESIE LLC
Other - Org Name:LAKE VIEW FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROVIDER/ AO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GIESIE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-490-6595
Mailing Address - Street 1:S74W17086 JANESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MUSKEGO
Mailing Address - State:WI
Mailing Address - Zip Code:53150-8619
Mailing Address - Country:US
Mailing Address - Phone:262-490-6595
Mailing Address - Fax:
Practice Address - Street 1:S74W17086 JANESVILLE RD
Practice Address - Street 2:
Practice Address - City:MUSKEGO
Practice Address - State:WI
Practice Address - Zip Code:53150-8619
Practice Address - Country:US
Practice Address - Phone:262-490-6595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty