Provider Demographics
NPI:1477680064
Name:CHIROPRACTIC HEALTH CLINIC
Entity Type:Organization
Organization Name:CHIROPRACTIC HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAEGAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-347-2222
Mailing Address - Street 1:2549 JOLLY RD
Mailing Address - Street 2:STE 360
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-3678
Mailing Address - Country:US
Mailing Address - Phone:517-347-2222
Mailing Address - Fax:517-347-2233
Practice Address - Street 1:2549 JOLLY RD
Practice Address - Street 2:STE 360
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3678
Practice Address - Country:US
Practice Address - Phone:517-347-2222
Practice Address - Fax:517-347-2233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004677111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty