1437329398 NPI number — ADRIAN CHIROPRACTIC CENTER, P.C.

Table of content: (NPI 1437329398)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437329398 NPI number — ADRIAN CHIROPRACTIC CENTER, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADRIAN CHIROPRACTIC CENTER, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437329398
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1921 E US HIGHWAY 223
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ADRIAN
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49221-1242
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
517-263-2900
Provider Business Mailing Address Fax Number:
517-263-9250

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1921 US HIGHWAY 223
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ADRIAN
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49221-1242
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-263-2900
Provider Business Practice Location Address Fax Number:
517-263-9250
Provider Enumeration Date:
03/06/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MCLOUGHLIN
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
EDWARD
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
517-263-6812

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2301002877 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 11780661520 . This is a "NPI TYPE 1 1780661520" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 11283335 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: P105344 . This is a "BCN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: $$$$$$$$$ . This is a "SSN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 649531 . This is a "ACN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: T82891 . This is a "UPIN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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