Provider Demographics
NPI:1518084292
Name:HEALTHZONE CHIROPRACTIC II
Entity Type:Organization
Organization Name:HEALTHZONE CHIROPRACTIC II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:VIRGIL
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:269-684-6354
Mailing Address - Street 1:70 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-2200
Mailing Address - Country:US
Mailing Address - Phone:269-684-6354
Mailing Address - Fax:269-684-6403
Practice Address - Street 1:70 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:MI
Practice Address - Zip Code:49120-2200
Practice Address - Country:US
Practice Address - Phone:269-684-6354
Practice Address - Fax:269-684-6403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI008877111NT0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NT0100XChiropractic ProvidersChiropractorThermographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0A11077OtherBCBS PROVIDER #
MIC0GQSOtherBCBS SUBMITTER ID
MI0A11077OtherBCBS PROVIDER #
MIC0GQSOtherBCBS SUBMITTER ID