Provider Demographics
NPI:1679691364
Name:CORBIT, DOROTHY SUZETTE (DC)
Entity Type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:SUZETTE
Last Name:CORBIT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 VETERANS DR STE 215
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-4575
Mailing Address - Country:US
Mailing Address - Phone:231-933-9388
Mailing Address - Fax:
Practice Address - Street 1:3301 VETERANS DR STE 215
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-4575
Practice Address - Country:US
Practice Address - Phone:231-933-9388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005922111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B85040OtherBCBS PROVIDER ID NUMBER
MI0M71450Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
MI0B85040OtherBCBS PROVIDER ID NUMBER