Provider Demographics
NPI:1659436251
Name:CALLTON, MICHAEL NORMAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:NORMAN
Last Name:CALLTON
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:PO BOX 676
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49073-0676
Mailing Address - Country:US
Mailing Address - Phone:517-852-2070
Mailing Address - Fax:517-852-1979
Practice Address - Street 1:307 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:MI
Practice Address - Zip Code:49073-9578
Practice Address - Country:US
Practice Address - Phone:517-852-2070
Practice Address - Fax:517-852-1979
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMC005548111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2691007Medicaid
MIU29998Medicare UPIN
MI2691007Medicaid