Provider Demographics
NPI:1083991756
Name:CALLIGAN, CHRISTOPHER CODY SIRIUS (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:CODY SIRIUS
Last Name:CALLIGAN
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 1:6358 CHERRY TREE CT
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306-3308
Mailing Address - Country:US
Mailing Address - Phone:517-610-2102
Mailing Address - Fax:
Practice Address - Street 1:200 W AVON RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2702
Practice Address - Country:US
Practice Address - Phone:248-601-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009886111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP27830005Medicare PIN