Provider Demographics
NPI:1063660967
Name:HEALTHZONE CHIROPRACTIC 10 PC
Entity Type:Organization
Organization Name:HEALTHZONE CHIROPRACTIC 10 PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-748-4400
Mailing Address - Street 1:PO BOX 1018
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49734-5018
Mailing Address - Country:US
Mailing Address - Phone:989-748-4400
Mailing Address - Fax:
Practice Address - Street 1:2119 HASLETT RD STE A
Practice Address - Street 2:
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-8669
Practice Address - Country:US
Practice Address - Phone:517-853-2027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005823111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty