Provider Demographics
NPI:1205915568
Name:NEW BERLIN CHIROPRACTIC AND THERAPY CENTER SC
Entity type:Organization
Organization Name:NEW BERLIN CHIROPRACTIC AND THERAPY CENTER SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:KOSHICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-785-8989
Mailing Address - Street 1:15800 W NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-5121
Mailing Address - Country:US
Mailing Address - Phone:262-785-8989
Mailing Address - Fax:262-785-8992
Practice Address - Street 1:15800 W NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-5121
Practice Address - Country:US
Practice Address - Phone:262-785-8989
Practice Address - Fax:262-785-8992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty