Individual
DR. COREY MICHAEL VAN WESTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
15850 W BLUEMOUND RD, SUITE 306, BROOKFIELD, WI 53005-6022
(262) 226-8349
(262) 226-8352
Mailing address
15850 W BLUEMOUND RD, SUITE 306, BROOKFIELD, WI 53005-6022
(262) 226-8349
(262) 226-8352
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
4410-12
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002627
—
WI
01
—
1275814345
GROUP NPI
WI
01
—
15886284733
INDIVIDUAL NPI
WI
01
—
39576
BLUE CROSS BLUE SHIELD
IA
Enumeration date
04/17/2006
Last updated
02/05/2016
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