Provider Demographics
NPI:1336504000
Name:KEHRES HEALTH AND CHIROPRACTIC
Entity Type:Organization
Organization Name:KEHRES HEALTH AND CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:KEHRES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-295-4357
Mailing Address - Street 1:4805 TOWNE CENTRE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-2831
Mailing Address - Country:US
Mailing Address - Phone:989-607-4322
Mailing Address - Fax:989-401-4555
Practice Address - Street 1:4805 TOWNE CENTRE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2831
Practice Address - Country:US
Practice Address - Phone:989-607-4322
Practice Address - Fax:989-401-4555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-23
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009633111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========Medicaid
MI=========Medicaid