Provider Demographics
NPI:1174879365
Name:CHIROPRACTIC MANAGEMENT SERVICES, LLC
Entity type:Organization
Organization Name:CHIROPRACTIC MANAGEMENT SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORSI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-513-9999
Mailing Address - Street 1:1427 E RACINE AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-6468
Mailing Address - Country:US
Mailing Address - Phone:262-513-9999
Mailing Address - Fax:
Practice Address - Street 1:1427 E RACINE AVE
Practice Address - Street 2:SUITE G
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-6468
Practice Address - Country:US
Practice Address - Phone:262-513-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-25
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty