Individual
MR. JEREMY L BRIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
450 MILL ST, SUITE 102, FONTANA, WI 53125-1242
(262) 275-5005
(262) 275-5004
Mailing address
450 MILL ST, SUITE 102, FONTANA, WI 53125-1242
(262) 275-5005
(262) 275-5004
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4188-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38966200
—
WI
Enumeration date
12/06/2006
Last updated
07/08/2007
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