Provider Demographics
NPI:1679624050
Name:WINKLER, MICHAEL W (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:W
Last Name:WINKLER
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 5345
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49696-5345
Mailing Address - Country:US
Mailing Address - Phone:231-922-8080
Mailing Address - Fax:231-922-8081
Practice Address - Street 1:115 E 14TH ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-3220
Practice Address - Country:US
Practice Address - Phone:231-922-8080
Practice Address - Fax:231-922-8081
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2016-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005055111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1609970Medicaid
MI950B85022-0OtherBCBS
MI950B85022-0OtherBCBS
MI1609970Medicaid