ALIGN CHIROPRACTIC OF PORT, S.C. (NPI# 1588792600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588792600 |
| Entity Type | Organization |
| Organization Name | ALIGN CHIROPRACTIC OF PORT, S.C. |
| Other Organization Name | BROOKS CLINIC OF PORT, S.C. |
| Practice Address |
1032 S Spring St Port Washington WI 53074-2455 |
| Practice Telephone | 2622840500 |
| Practice Fax Number | 2622841944 |
| Mailing Telephone | 2622840500 |
| Mailing Fax Number | 2622841944 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2017-11-02 |
| Authorized Official Name | DR. JACOB J CHAPMAN (PRESIDENT) |
| Authorized Official Telephone | 2622840500 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 1323 | WI | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 38986700 | 05 |
| Other Name | Type Code |
|---|---|
| Brooks Clinic of Port, S.C. | Former Legal Business Name - Organization |
| Street Address |
1032 S SPRING ST |
| City | PORT WASHINGTON |
| State | WI |
| Zip Code | 53074-2455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275645392 | Phillip L. Brooks | Chiropractor | 1032 S Spring St, Port Washington, WI 53074-2455 | 2006-08-31 |
| 1538498522 | Jacob J Chapman | Chiropractor | 1032 S Spring St, Port Washington, WI 53074-2455 | 2009-12-22 |
| 1194894139 | Crystal Ann Brooks | Dentist | 1032 S Spring St, Port Washington, WI 53074-2455 | 2006-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962045864 | Heather Kay Brede | Technician | 857 Ashley Avenue, Port Washington, WI 53074 | 2019-10-23 |
| 1780062034 | Amanda Zitzer | Specialist/Technologist | 1037 S Spring Street, Apt 257, Port Washington, WI 53074 | 2015-05-07 |
| 1639507643 | Kelly Mulder | Occupational Therapy Assistant | 138 E Prospect St, Port Washington, WI 53074 | 2013-10-30 |
| 1235310921 | Susan Ann Dobberpuhl | Occupational Therapist | 306 N Sprint St, Port Washington, WI 53074 | 2007-11-21 |
| 1245444736 | Lee B Raffel | Social Worker | 3632 E Norport Drive, Port Washington, WI 53074 | 2007-05-10 |
| 1023143708 | Joshua E Leute | Dentist | 1317 West Grand Avenue, Port Washington, WI 53074 | 2007-02-22 |
| 1578633806 | Robert Andrew Kortsch | Dentist | 457 W Grand Ave, Port Washington, WI 53074 | 2006-11-08 |
| 1538256409 | Daniel P Witkowski | Dentist | 1612 N Wisconsin St, Port Washington, WI 53074 | 2006-10-10 |
| 1477584878 | Francine L Cosner | Obstetrics & Gynecology | 1777 W Grand Avenue, Port Washington, WI 53074 | 2006-07-05 |
| 1013953926 | Port Washington Podiatry Inc | Podiatrist | 1317 W Grand Avenue, Port Washington Podiatry, Port Washington, WI 53074 | 2006-06-20 |
| Find all providers in zip 53074 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861679219 | Robyn P Croutch | Chiropractor | 12 Irma Avenue, Port Washington, NY 11050 | 2008-01-29 |
| 1407057144 | Deborah Kleinman-cindrich | Chiropractor | 33 Sandy Hollow Rd, Port Washington, NY 11050-2530 | 2007-05-30 |
| 1538288964 | Allen R Spaude | Chiropractor | 218 N Franklin St, Port Washington, WI 53074-1903 | 2007-03-28 |
| 1912025750 | Michael Charles Ross | Chiropractor | 1454 Apple Ct, Port Washington, WI 53074-2490 | 2007-03-27 |
| 1962550103 | Star Anthony | Chiropractor | 64 Beacon Hill Rd, Port Washington, NY 11050-3034 | 2007-01-06 |
| 1225107626 | Marie T Eagan | Chiropractor | 20 Vanderventer Ave Ste 100e, Port Washington, NY 11050-3752 | 2006-11-07 |
| 1790867273 | Charles A. Schnier | Chiropractor | 18 Haven Avenue, Suite 200, Port Washington, NY 11050-3642 | 2006-10-20 |
| 1275645392 | Phillip L. Brooks | Chiropractor | 1032 S Spring St, Port Washington, WI 53074-2455 | 2006-08-31 |
| 1649389339 | Robin Rhonda Bromberg | Chiropractor | 20 Vanderventer Ave, Suite 100, Port Washington, NY 11050-3752 | 2006-08-29 |
| 1124049929 | Kathleen Jozef | Chiropractor | 14 Vanderventer Avenue, Suite #l3c, Port Washington, NY 11050-3737 | 2006-07-21 |
| Find all providers in PORT WASHINGTON | ||||
| City | PORT WASHINGTON |
| Zip Code | 53074 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.