Provider Demographics
NPI:1083634851
Name:MIDDLETON, ALLAN J (DC)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:J
Last Name:MIDDLETON
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 1:701 BEECH ST
Mailing Address - Street 2:PO BOX 325
Mailing Address - City:CLARE
Mailing Address - State:MI
Mailing Address - Zip Code:48617-1427
Mailing Address - Country:US
Mailing Address - Phone:989-386-2384
Mailing Address - Fax:989-386-2105
Practice Address - Street 1:701 BEECH ST
Practice Address - Street 2:
Practice Address - City:CLARE
Practice Address - State:MI
Practice Address - Zip Code:48617-1427
Practice Address - Country:US
Practice Address - Phone:989-386-2384
Practice Address - Fax:989-386-2105
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI002263111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIAM002263OtherBCBS OF MI
MI4470103Medicaid