Provider Demographics
NPI:1568401974
Name:DENHOLM FAMILY CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:DENHOLM FAMILY CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:DENHOLM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-348-6600
Mailing Address - Street 1:6838 M 93 HWY S
Mailing Address - Street 2:
Mailing Address - City:GRAYLING
Mailing Address - State:MI
Mailing Address - Zip Code:49738-7766
Mailing Address - Country:US
Mailing Address - Phone:989-348-6600
Mailing Address - Fax:989-348-3537
Practice Address - Street 1:6838 M 93 HWY S
Practice Address - Street 2:
Practice Address - City:GRAYLING
Practice Address - State:MI
Practice Address - Zip Code:49738-7766
Practice Address - Country:US
Practice Address - Phone:989-348-6600
Practice Address - Fax:989-348-3537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICD005021111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M94740Medicare ID - Type Unspecified