Provider Demographics
NPI:1568528370
Name:BURKHART CHIROPRACTIC PLC
Entity Type:Organization
Organization Name:BURKHART CHIROPRACTIC PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKHART
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:616-698-0046
Mailing Address - Street 1:7101 BROADMOOR AVE SE
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-9510
Mailing Address - Country:US
Mailing Address - Phone:616-698-0046
Mailing Address - Fax:
Practice Address - Street 1:7101 BROADMOOR AVE SE
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316-9510
Practice Address - Country:US
Practice Address - Phone:616-698-0046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N71560Medicare ID - Type Unspecified