Provider Demographics
NPI:1184176927
Name:MCKEE, NATHANIAL PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:NATHANIAL
Middle Name:PAUL
Last Name:MCKEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:SHANNON
Other - Middle Name:RAE
Other - Last Name:MCKEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC DPLAC, RAC
Mailing Address - Street 1:1510 S STATE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423
Mailing Address - Country:US
Mailing Address - Phone:810-223-2439
Mailing Address - Fax:810-616-5900
Practice Address - Street 1:1510 S STATE RD
Practice Address - Street 2:SUITE C
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423
Practice Address - Country:US
Practice Address - Phone:810-223-2439
Practice Address - Fax:810-616-5900
Is Sole Proprietor?:No
Enumeration Date:2016-10-27
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010492111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor