Provider Demographics
NPI:1710203997
Name:GEARY, PETER GREGORY (DC)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:GREGORY
Last Name:GEARY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16655 W WISCONSIN AVE STE 106B
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-5718
Mailing Address - Country:US
Mailing Address - Phone:262-293-6871
Mailing Address - Fax:
Practice Address - Street 1:16655 W WISCONSIN AVE STE 106B
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-5718
Practice Address - Country:US
Practice Address - Phone:262-293-6871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4610-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor