East Side Chiropractic and Laser Therapy Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

EAST SIDE CHIROPRACTIC AND LASER THERAPY CENTER LLC

Doing business as

East Side Chiropractic

Practice address

1624 E Mason St
Green Bay, WI 54302-2739

Phone

(920) 465-0400

NPI assigned

Mar 30, 2022

Last updated

Apr 10, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Zastrow, D.C.NPI 1275586075

Title

Owner

Phone

(209) 465-0400

Specialties & licenses 2

Addresses

Other names 1

• East Side Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Lawrence Zastrow, D.C.

  • Chiropractor
  • Green Bay, WI
  • NPI 1275586075
  Medicare reassignment NPD Authorized official
• Isaiah J Griesbach, D.C.

  • Chiropractor
  • Green Bay, WI
  • NPI 1447917703
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1508506353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 E MASON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543022739",
            "telephone_number": "920-465-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 E MASON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543022739",
            "telephone_number": "920-465-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SIDE CHIROPRACTIC AND LASER THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-30",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A",
        "authorized_official_last_name": "ZASTROW",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-465-0400",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Side Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "East Side Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Haley N Dyer, MS
• Dynamic Chiropractic, LTD
• Peter Dzwonkowski, MD
• Donna Kay Eads, LCSW
• Rene Martin Earles, MD
• East Side Family Practice SC
• Eastridge Dental Associates, S.C. (Eastridge Dental)
• Benjamin James Ebben, MD
• Emily M Ebben, LPC
• James Robert Ebben, MD

• Chiropractor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.