Provider Demographics
NPI:1306025242
Name:CORUNNA CHIROPRACTIC CENTRE, P.C.
Entity Type:Organization
Organization Name:CORUNNA CHIROPRACTIC CENTRE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:K
Authorized Official - Last Name:BILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-743-3515
Mailing Address - Street 1:PO BOX 17
Mailing Address - Street 2:
Mailing Address - City:CORUNNA
Mailing Address - State:MI
Mailing Address - Zip Code:48817-0017
Mailing Address - Country:US
Mailing Address - Phone:989-743-3515
Mailing Address - Fax:
Practice Address - Street 1:227 N SHIAWASSEE ST
Practice Address - Street 2:
Practice Address - City:CORUNNA
Practice Address - State:MI
Practice Address - Zip Code:48817-1437
Practice Address - Country:US
Practice Address - Phone:989-743-3515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-28
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIKB007405111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M37610Medicare PIN