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Organization

GENESIS CHIROPRACTIC CLINIC, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DANIEL CHARLES ESPOSITO DC (CEO)
(262) 657-7744
Entity
Organization

Contact information

Practice address
1024 60TH ST, KENOSHA, WI 53140-4099
(262) 657-7744
Mailing address
1024 60TH ST, KENOSHA, WI 53140-4099
(262) 657-7744

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3168-12
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38887800
WI
Enumeration date
11/29/2006
Last updated
08/22/2020
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