Provider Demographics
NPI:1518132695
Name:RICHLAND CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:RICHLAND CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:PIGNATARO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:269-692-5006
Mailing Address - Street 1:9800 M 89
Mailing Address - Street 2:SUITE 9801
Mailing Address - City:RICHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49083
Mailing Address - Country:US
Mailing Address - Phone:269-692-5006
Mailing Address - Fax:269-692-5009
Practice Address - Street 1:9800 M 89
Practice Address - Street 2:SUITE 9801
Practice Address - City:RICHLAND
Practice Address - State:MI
Practice Address - Zip Code:49083
Practice Address - Country:US
Practice Address - Phone:269-692-5006
Practice Address - Fax:269-692-5009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008437111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty