Provider Demographics
NPI:1386835882
Name:HANCE FAMILY CHIROPRACTIC CARE PLLC
Entity Type:Organization
Organization Name:HANCE FAMILY CHIROPRACTIC CARE PLLC
Other - Org Name:HANCE FAMILY CHIROPRACTIC CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LUELLA
Authorized Official - Last Name:HANCE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:898-366-3000
Mailing Address - Street 1:3508 W HOUGHTON LAKE DRIVE
Mailing Address - Street 2:
Mailing Address - City:HOUGHTON LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48629
Mailing Address - Country:US
Mailing Address - Phone:989-366-3000
Mailing Address - Fax:989-366-3000
Practice Address - Street 1:3508 W HOUGHTON LAKE DRIVE
Practice Address - Street 2:
Practice Address - City:HOUGHTON LAKE
Practice Address - State:MI
Practice Address - Zip Code:48629
Practice Address - Country:US
Practice Address - Phone:989-366-3000
Practice Address - Fax:989-366-3000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU68455Medicare UPIN