Provider Demographics
NPI:1891490496
Name:MARITIME CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:MARITIME CHIROPRACTIC LLC
Other - Org Name:LINZMEIER CHIROPRACTIC S.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR/MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:A
Authorized Official - Last Name:BUSS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:920-997-9740
Mailing Address - Street 1:645 W RIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-1254
Mailing Address - Country:US
Mailing Address - Phone:920-997-9740
Mailing Address - Fax:920-997-9748
Practice Address - Street 1:210 E REED AVE
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-2121
Practice Address - Country:US
Practice Address - Phone:920-682-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty