Provider Demographics
NPI:1750689394
Name:GINGELL CHIROPRACTIC CENTER PC
Entity Type:Organization
Organization Name:GINGELL CHIROPRACTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GINGELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:745-453-2447
Mailing Address - Street 1:9450 S MAIN ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4184
Mailing Address - Country:US
Mailing Address - Phone:734-453-2447
Mailing Address - Fax:
Practice Address - Street 1:9450 S MAIN ST
Practice Address - Street 2:SUITE 106
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-4184
Practice Address - Country:US
Practice Address - Phone:734-453-2447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0Q25084Medicare PIN