Provider Demographics
NPI:1437383429
Name:ALLEN CHIROPRACTIC HEALTH CENTER
Entity Type:Organization
Organization Name:ALLEN CHIROPRACTIC HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:F
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:231-832-3234
Mailing Address - Street 1:21717 HOWARD ST
Mailing Address - Street 2:PO BOX 208
Mailing Address - City:REED CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49677
Mailing Address - Country:US
Mailing Address - Phone:231-832-3234
Mailing Address - Fax:231-832-4557
Practice Address - Street 1:21717 HOWARD ST
Practice Address - Street 2:
Practice Address - City:REED CITY
Practice Address - State:MI
Practice Address - Zip Code:49677
Practice Address - Country:US
Practice Address - Phone:231-832-3234
Practice Address - Fax:231-832-4557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005223111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950F75003OtherBCBS
MI0M90420Medicare UPIN