Provider Demographics
NPI:1710012794
Name:GIORDANO, GUY CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:GUY
Middle Name:CHARLES
Last Name:GIORDANO
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 1:4573 WILLOUGHBY RD STE B
Mailing Address - Street 2:
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-2188
Mailing Address - Country:US
Mailing Address - Phone:517-699-2646
Mailing Address - Fax:517-699-5434
Practice Address - Street 1:4573 WILLOUGHBY RD STE B
Practice Address - Street 2:
Practice Address - City:HOLT
Practice Address - State:MI
Practice Address - Zip Code:48842-2188
Practice Address - Country:US
Practice Address - Phone:517-699-2646
Practice Address - Fax:517-699-5434
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIGG006617111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
950D710590OtherBCBS
MI0P01780Medicare ID - Type UnspecifiedMEDICARE