Provider Demographics
NPI:1023060860
Name:TUTTLE, CALVIN J (DC)
Entity type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:J
Last Name:TUTTLE
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 1:402 E CHICAGO BLVD
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:MI
Mailing Address - Zip Code:49286-1665
Mailing Address - Country:US
Mailing Address - Phone:517-423-7414
Mailing Address - Fax:517-423-7415
Practice Address - Street 1:402 E CHICAGO BLVD
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:MI
Practice Address - Zip Code:49286-1665
Practice Address - Country:US
Practice Address - Phone:517-423-7414
Practice Address - Fax:517-423-7415
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004075111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2730830Medicaid
MIT33080Medicare UPIN
MI2730830Medicaid