Provider Demographics
NPI:1053441188
Name:TRAINOR, JOHN DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:TRAINOR
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 1:4195 S CANTON CENTER RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-2489
Mailing Address - Country:US
Mailing Address - Phone:734-397-3779
Mailing Address - Fax:734-397-3776
Practice Address - Street 1:4195 S CANTON CENTER RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-2489
Practice Address - Country:US
Practice Address - Phone:734-397-3779
Practice Address - Fax:734-397-3776
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008878111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIJT008878OtherBCBS INDIVIDUAL
MIJT008878OtherBCBS INDIVIDUAL
MIV01176Medicare UPIN