Provider Demographics
NPI:1407186802
Name:APPLEGATE VENTURES, PLLC
Entity Type:Organization
Organization Name:APPLEGATE VENTURES, PLLC
Other - Org Name:MCGINNIS CHIROPRACTIC HEALING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOEMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:810-982-6115
Mailing Address - Street 1:3825 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT GRATIOT
Mailing Address - State:MI
Mailing Address - Zip Code:48059-4100
Mailing Address - Country:US
Mailing Address - Phone:810-982-6115
Mailing Address - Fax:
Practice Address - Street 1:3825 24TH AVE
Practice Address - Street 2:
Practice Address - City:FORT GRATIOT
Practice Address - State:MI
Practice Address - Zip Code:48059-4100
Practice Address - Country:US
Practice Address - Phone:810-982-6115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004518261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service