Provider Demographics
NPI:1780849224
Name:CHISM CHIROPRACTIC CLINIC PC
Entity Type:Organization
Organization Name:CHISM CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:CHISM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-296-4800
Mailing Address - Street 1:32235 UTICA RD
Mailing Address - Street 2:
Mailing Address - City:FRASER
Mailing Address - State:MI
Mailing Address - Zip Code:48026-3829
Mailing Address - Country:US
Mailing Address - Phone:586-296-4800
Mailing Address - Fax:
Practice Address - Street 1:32235 UTICA RD
Practice Address - Street 2:
Practice Address - City:FRASER
Practice Address - State:MI
Practice Address - Zip Code:48026-3829
Practice Address - Country:US
Practice Address - Phone:586-296-4800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-24
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty