Provider Demographics
NPI:1659938447
Name:CALVERT, JAMES AUSTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:AUSTIN
Last Name:CALVERT
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 1:2439 CAMPAU AVE
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-2565
Mailing Address - Country:US
Mailing Address - Phone:810-357-9557
Mailing Address - Fax:
Practice Address - Street 1:1025 HURON AVE
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3763
Practice Address - Country:US
Practice Address - Phone:810-294-5678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-28
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010824111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor