Provider Demographics
NPI:1346662848
Name:AMERICAN CHIROPRACTIC MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:AMERICAN CHIROPRACTIC MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:AAFERTI-ELRA
Authorized Official - Middle Name:AMON
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:810-420-0801
Mailing Address - Street 1:621 CHARTIER
Mailing Address - Street 2:SUITEB
Mailing Address - City:MARINE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48039-2350
Mailing Address - Country:US
Mailing Address - Phone:810-420-0804
Mailing Address - Fax:
Practice Address - Street 1:621 CHARTIER STE B
Practice Address - Street 2:
Practice Address - City:MARINE CITY
Practice Address - State:MI
Practice Address - Zip Code:48039-2350
Practice Address - Country:US
Practice Address - Phone:810-420-0804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-17
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty