Provider Demographics
NPI:1073828901
Name:GLENN A PARTRIDGE DC PLC
Entity Type:Organization
Organization Name:GLENN A PARTRIDGE DC PLC
Other - Org Name:GRAND BLANC CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:ARNOLD
Authorized Official - Last Name:PARTRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:810-695-1489
Mailing Address - Street 1:PO BOX 531
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48480-0531
Mailing Address - Country:US
Mailing Address - Phone:810-695-1489
Mailing Address - Fax:810-695-1514
Practice Address - Street 1:3102 E GRAND BLANC RD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8116
Practice Address - Country:US
Practice Address - Phone:810-695-1489
Practice Address - Fax:810-695-1514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty