Provider Demographics
NPI:1184642563
Name:SCOTT A KRIBS CHIROPRACTOR INC
Entity Type:Organization
Organization Name:SCOTT A KRIBS CHIROPRACTOR INC
Other - Org Name:KRIBS WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:KRIBS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-485-1967
Mailing Address - Street 1:809 CENTER ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48906-5258
Mailing Address - Country:US
Mailing Address - Phone:517-485-1967
Mailing Address - Fax:517-485-6919
Practice Address - Street 1:809 CENTER ST
Practice Address - Street 2:SUITE 2
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48906-5258
Practice Address - Country:US
Practice Address - Phone:517-485-1967
Practice Address - Fax:517-485-6919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2001007847111N00000X
MI2301008406111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI95OC313840OtherBCBSM GROUP PIN #
MI95OC313840OtherBCBSM GROUP PIN #