Provider Demographics
NPI:1568523934
Name:PINCONNING AREA CHIROPRACTIC CENTER INC
Entity Type:Organization
Organization Name:PINCONNING AREA CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:TROMBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-879-8133
Mailing Address - Street 1:PO BOX 706
Mailing Address - Street 2:1948 N HURON RD
Mailing Address - City:PINCONNING
Mailing Address - State:MI
Mailing Address - Zip Code:48650-7909
Mailing Address - Country:US
Mailing Address - Phone:989-879-8133
Mailing Address - Fax:
Practice Address - Street 1:1948 N HURON RD
Practice Address - Street 2:
Practice Address - City:PINCONNING
Practice Address - State:MI
Practice Address - Zip Code:48650-7909
Practice Address - Country:US
Practice Address - Phone:989-879-8133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008083111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI44707OtherMOLINA
MIP00074807OtherMEDICARE RAILROAD
MIP109392OtherHEALTH PLUS
MI1009925OtherMCLAREN HEALTH ADVANTAGE
MI4458898Medicaid
MI950Z950250OtherBLUE CROSS BLUE SHEILD
MI4458898Medicaid
MIU80339Medicare UPIN
MI4458898Medicaid