1760614572 NPI number — HEALTH FIRST CHIROPRACTIC CLINIC OF MIDLAND, P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760614572 NPI number — HEALTH FIRST CHIROPRACTIC CLINIC OF MIDLAND, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH FIRST CHIROPRACTIC CLINIC OF MIDLAND, 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:
1760614572
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/12/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3097 29TH ST SE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND RAPIDS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49512-1726
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
616-974-9922
Provider Business Mailing Address Fax Number:
616-974-9955

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2713 RODD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDLAND
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48640-4403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-835-2200
Provider Business Practice Location Address Fax Number:
989-698-3171
Provider Enumeration Date:
08/12/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SZAGESH
Authorized Official First Name:
ALAN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
616-974-9922

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2301007582 , 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)





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