Provider Demographics
NPI:1639195100
Name:JEFFRIES CHIROPRACTIC ALTERNATIVE HEALING CENTRE P.C.
Entity Type:Organization
Organization Name:JEFFRIES CHIROPRACTIC ALTERNATIVE HEALING CENTRE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:WALLACE
Authorized Official - Last Name:JEFFRIES
Authorized Official - Suffix:IV
Authorized Official - Credentials:DC
Authorized Official - Phone:906-226-7525
Mailing Address - Street 1:708 CHIPPEWA SQUARE
Mailing Address - Street 2:#5
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855
Mailing Address - Country:US
Mailing Address - Phone:906-226-7525
Mailing Address - Fax:906-226-7525
Practice Address - Street 1:708 CHIPPEWA SQUARE
Practice Address - Street 2:#5
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855
Practice Address - Country:US
Practice Address - Phone:906-226-7525
Practice Address - Fax:906-226-7525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007181111N00000X
SC2746111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOE25005OtherBXBS
MI0M21790Medicare PIN
MIOE25005OtherBXBS