Provider Demographics
NPI:1497915482
Name:DISCOVER CHIROPRACTIC
Entity Type:Organization
Organization Name:DISCOVER CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:MCHENRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-393-8800
Mailing Address - Street 1:6425 S PENNSYLVANIA AVE
Mailing Address - Street 2:STE 17
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-5975
Mailing Address - Country:US
Mailing Address - Phone:517-393-8800
Mailing Address - Fax:517-393-9000
Practice Address - Street 1:6425 S PENNSYLVANIA AVE
Practice Address - Street 2:STE 17
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-5975
Practice Address - Country:US
Practice Address - Phone:517-393-8800
Practice Address - Fax:517-393-9000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008401111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1001609OtherMCLAREN MEDICAID
MI950C350910OtherBLUE CARE NETWORK
MI950C350910OtherBCBS
MI1018045OtherMCLAREN HEALTH ADVANTAGE
MI0N30100OtherMEDICARE ADVANTAGE
MI133365OtherPREFERRED CHOICES
MI200000002377OtherPHP
MI8115915OtherCIGNA
MI0N30100OtherMEDICARE PLUS BLUE
MI4308531Medicaid
MI1018045OtherMCLAREN HEALTH ADVANTAGE