Provider Demographics
NPI:1922098359
Name:PULVER, JOSHUA DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:DEAN
Last Name:PULVER
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 1:600 CHARLEVOIX AVE
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2299
Mailing Address - Country:US
Mailing Address - Phone:231-348-7540
Mailing Address - Fax:231-348-7621
Practice Address - Street 1:600 CHARLEVOIX AVE
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2299
Practice Address - Country:US
Practice Address - Phone:231-348-7540
Practice Address - Fax:231-348-7621
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008832111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIV03210Medicare UPIN
MIP20660001Medicare ID - Type Unspecified