Provider Demographics
NPI:1568687291
Name:GILBERT, KRISTIN K (DC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:K
Last Name:GILBERT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W ELM ST
Mailing Address - Street 2:
Mailing Address - City:CHEBOYGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49721-1622
Mailing Address - Country:US
Mailing Address - Phone:231-597-9999
Mailing Address - Fax:231-597-1042
Practice Address - Street 1:401 W ELM ST
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721-1622
Practice Address - Country:US
Practice Address - Phone:231-597-9999
Practice Address - Fax:231-597-1042
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008412111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4440220Medicaid
MI950A650210OtherBCBS OF MICHIGAN
MI4440220Medicaid
MI950A650210OtherBCBS OF MICHIGAN