Provider Demographics
NPI:1659383271
Name:KIRSHNER, TODD (DC)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:
Last Name:KIRSHNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 ECORSE RD
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-5985
Mailing Address - Country:US
Mailing Address - Phone:734-482-7700
Mailing Address - Fax:734-482-8805
Practice Address - Street 1:1412 ECORSE RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-5985
Practice Address - Country:US
Practice Address - Phone:734-482-7700
Practice Address - Fax:734-482-8805
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004165111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950H112780OtherBCBS
MI2117586Medicaid
MI0H15061Medicare PIN