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Organization
CHIROPRACTIC COMPANY S.C.
Active
Organization
CHIROPRACTIC COMPANY S.C.
Active
Other names
Chiropractic Company
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN R GERONDALE DC CC SP (PRESIDENT)
(414) 332-0859
Entity
Organization
Contact information
Practice address
5306 N PORT WASHINGTON RD, GLENDALE, WI 53217-4913
(414) 332-0859
(414) 332-3991
Mailing address
5306 N PORT WASHINGTON RD, GLENDALE, WI 53217-4913
(414) 332-0859
(414) 332-3991
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38989100
—
WI
Enumeration date
12/21/2006
Last updated
08/12/2020
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