Provider Demographics
NPI:1003193244
Name:DR JAMES SPENCER JR CHIROPRACTIC CENTER PLC
Entity Type:Organization
Organization Name:DR JAMES SPENCER JR CHIROPRACTIC CENTER PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CLIFFORD
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:517-448-3000
Mailing Address - Street 1:PO BOX 111
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MI
Mailing Address - Zip Code:49247-0111
Mailing Address - Country:US
Mailing Address - Phone:517-448-3000
Mailing Address - Fax:517-448-6900
Practice Address - Street 1:509 S MERIDIAN RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:MI
Practice Address - Zip Code:49247-9341
Practice Address - Country:US
Practice Address - Phone:517-448-3000
Practice Address - Fax:517-448-6900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005974111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty