Provider Demographics
NPI:1659582344
Name:FAMILY CHIROPRACTIC CLINIC PC
Entity Type:Organization
Organization Name:FAMILY CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:NORR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-774-4911
Mailing Address - Street 1:815 PYLE DR
Mailing Address - Street 2:
Mailing Address - City:KINGSFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49802-4454
Mailing Address - Country:US
Mailing Address - Phone:906-774-4911
Mailing Address - Fax:906-776-1778
Practice Address - Street 1:815 PYLE DR
Practice Address - Street 2:
Practice Address - City:KINGSFORD
Practice Address - State:MI
Practice Address - Zip Code:49802-4454
Practice Address - Country:US
Practice Address - Phone:906-774-4911
Practice Address - Fax:906-776-1778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty