Provider Demographics
NPI:1861797045
Name:CHIROPRACTIC COMPANY - BROWN DEER LTD
Entity type:Organization
Organization Name:CHIROPRACTIC COMPANY - BROWN DEER LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
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 1:11129 N WAUWATOSA RD
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53097-3431
Mailing Address - Country:US
Mailing Address - Phone:414-354-5377
Mailing Address - Fax:414-354-0523
Practice Address - Street 1:11129 N WAUWATOSA RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53097-3431
Practice Address - Country:US
Practice Address - Phone:414-354-5377
Practice Address - Fax:414-354-0523
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHIROPRACTIC COMPANY, S.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-19
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3810111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty