Provider Demographics
NPI:1346013315
Name:906 CHIROPRACTIC
Entity Type:Organization
Organization Name:906 CHIROPRACTIC
Other - Org Name:906 CHIROPRACTIC, PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTOR/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:
Authorized Official - Last Name:PASTOTNIK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:906-458-1437
Mailing Address - Street 1:16620 NOVAK RD
Mailing Address - Street 2:
Mailing Address - City:EWEN
Mailing Address - State:MI
Mailing Address - Zip Code:49925-9011
Mailing Address - Country:US
Mailing Address - Phone:906-458-1437
Mailing Address - Fax:
Practice Address - Street 1:13894 US HIGHWAY 45
Practice Address - Street 2:
Practice Address - City:BRUCE CROSSING
Practice Address - State:MI
Practice Address - Zip Code:49912
Practice Address - Country:US
Practice Address - Phone:906-458-1437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-01
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty