Provider Demographics
NPI:1073934469
Name:DR. MICHAEL A REMMICK, CHIROPRACTOR
Entity Type:Organization
Organization Name:DR. MICHAEL A REMMICK, CHIROPRACTOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:REMMICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-662-7538
Mailing Address - Street 1:201 6TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301-3025
Mailing Address - Country:US
Mailing Address - Phone:701-662-7538
Mailing Address - Fax:701-662-5025
Practice Address - Street 1:201 6TH AVE NE
Practice Address - Street 2:
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301-3025
Practice Address - Country:US
Practice Address - Phone:701-662-7538
Practice Address - Fax:701-662-5025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-02
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND396111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDMN76074REOtherMNBCBS
ND14298Medicaid
ND4311OtherNDBCBS
ND792350066OtherRAILROADMEDICARE
ND4311Medicare PIN
NDT66807Medicare UPIN