Provider Demographics
NPI:1003864349
Name:MCALPINE, JACK DEMONT (DC)
Entity Type:Individual
Prefix:DR
First Name:JACK
Middle Name:DEMONT
Last Name:MCALPINE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3985 N MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-1828
Mailing Address - Country:US
Mailing Address - Phone:989-771-2225
Mailing Address - Fax:989-754-2225
Practice Address - Street 1:7261 GRATIOT RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48609-6908
Practice Address - Country:US
Practice Address - Phone:989-781-7700
Practice Address - Fax:989-781-7733
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301003006111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN85990007Medicare ID - Type Unspecified