Provider Demographics
NPI:1912368051
Name:O'BRIEN, MICHELE PATRICIA (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:PATRICIA
Last Name:O'BRIEN
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 1:1519 E RIVER RD STE B
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49445-8591
Mailing Address - Country:US
Mailing Address - Phone:231-744-6400
Mailing Address - Fax:231-744-6464
Practice Address - Street 1:1519 E RIVER RD STE B
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49445-8591
Practice Address - Country:US
Practice Address - Phone:231-744-6400
Practice Address - Fax:231-744-6464
Is Sole Proprietor?:No
Enumeration Date:2016-03-17
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009265111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor