Provider Demographics
NPI:1386844538
Name:PREBISH CHIROPRACTIC PLC
Entity Type:Organization
Organization Name:PREBISH CHIROPRACTIC PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:DOWNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-965-3367
Mailing Address - Street 1:310 CAPITAL AVE SW
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49037-8680
Mailing Address - Country:US
Mailing Address - Phone:269-965-3367
Mailing Address - Fax:269-965-5753
Practice Address - Street 1:310 CAPITAL AVE SW
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49037-8680
Practice Address - Country:US
Practice Address - Phone:269-965-3367
Practice Address - Fax:269-965-5753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004056111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4724125Medicaid
MI4724116Medicaid
MI0N83750Medicare PIN
MIN83750001Medicare PIN
MIU93145Medicare UPIN
MI4724116Medicaid
MI4724125Medicaid