Organization
BRETT EGELSEER
Active
Other names
Advanced Spine Center
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JENNIFER C BOY (OFFICE MANAGER)
(920) 467-6281
Entity
Organization
Contact information
Practice address
11203 N BUNTROCK AVE, SUITE 100, MEQUON, WI 53092-1857
(262) 512-1661
(262) 512-1663
Mailing address
11203 N BUNTROCK AVE, SUITE 100, MEQUON, WI 53092-1857
(262) 512-1661
(262) 512-1663
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2649-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38898300
—
WI
Enumeration date
10/29/2007
Last updated
04/20/2008
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