1548442676 NPI number — TECUMSEH CHIROPRACTIC CENTER, INCORPORATED

Table of content: (NPI 1548442676)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548442676 NPI number — TECUMSEH CHIROPRACTIC CENTER, INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TECUMSEH CHIROPRACTIC CENTER, INCORPORATED
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:
1548442676
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/28/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 59
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TECUMSEH
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49286
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
517-423-7414
Provider Business Mailing Address Fax Number:
517-423-7415

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
402 EAST CHICAGO BLVD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TECUMSEH
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49286
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-423-7414
Provider Business Practice Location Address Fax Number:
517-423-7415
Provider Enumeration Date:
11/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TUTTLE
Authorized Official First Name:
CALVIN
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
517-423-7414

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2301004075 , 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)





Copyright © 2007-2024 www.npivalidator.com