Provider Demographics
NPI:1346433943
Name:FAMILY CHIROPRACTIC CLINIC OF SAGINAW, PLC
Entity Type:Organization
Organization Name:FAMILY CHIROPRACTIC CLINIC OF SAGINAW, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-792-1718
Mailing Address - Street 1:70 N FROST DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-5796
Mailing Address - Country:US
Mailing Address - Phone:989-792-1718
Mailing Address - Fax:
Practice Address - Street 1:70 N FROST DR
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-5796
Practice Address - Country:US
Practice Address - Phone:989-792-1718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P24840001Medicare UPIN