Provider Demographics
NPI:1902227507
Name:WASKEVICH FAMILY CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:WASKEVICH FAMILY CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:WASKEVCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-835-2440
Mailing Address - Street 1:901 E INDIAN ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-5397
Mailing Address - Country:US
Mailing Address - Phone:989-835-2440
Mailing Address - Fax:989-835-2442
Practice Address - Street 1:901 E INDIAN ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-5397
Practice Address - Country:US
Practice Address - Phone:989-835-2440
Practice Address - Fax:989-835-2442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-27
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008784111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty