Provider Demographics
NPI:1316218597
Name:T.J. NUGENT D.C., P.L.C.
Entity Type:Organization
Organization Name:T.J. NUGENT D.C., P.L.C.
Other - Org Name:T.J. NUGENT D.C., P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:T.J.
Authorized Official - Middle Name:
Authorized Official - Last Name:NUGENT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-835-8330
Mailing Address - Street 1:2931 MANOR DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-4476
Mailing Address - Country:US
Mailing Address - Phone:989-835-8330
Mailing Address - Fax:989-835-4906
Practice Address - Street 1:2931 MANOR DR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4476
Practice Address - Country:US
Practice Address - Phone:989-835-8330
Practice Address - Fax:989-835-4906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005042261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care