Provider Demographics
NPI:1417491762
Name:BEAR RIVER CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:BEAR RIVER CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:231-675-0146
Mailing Address - Street 1:2780 CHARLEVOIX AVE
Mailing Address - Street 2:SUITE 14
Mailing Address - City:BAY HARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49770-8058
Mailing Address - Country:US
Mailing Address - Phone:231-881-9391
Mailing Address - Fax:231-881-9392
Practice Address - Street 1:2780 CHARLEVOIX AVE
Practice Address - Street 2:SUITE 14
Practice Address - City:BAY HARBOR
Practice Address - State:MI
Practice Address - Zip Code:49770-8058
Practice Address - Country:US
Practice Address - Phone:231-675-0146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010376111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI863002Medicare PIN