Provider Demographics
NPI:1356417901
Name:SEMLOW CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:SEMLOW CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:R
Authorized Official - Last Name:SEMLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-798-9355
Mailing Address - Street 1:5353 GRAND HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49441-5985
Mailing Address - Country:US
Mailing Address - Phone:231-798-9355
Mailing Address - Fax:231-799-1777
Practice Address - Street 1:5353 GRAND HAVEN RD
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49441-5985
Practice Address - Country:US
Practice Address - Phone:231-798-9355
Practice Address - Fax:231-799-1777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007666111N00000X
MISS007666111N00000X
MI55007666111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4653981Medicaid
950F111190OtherBCBS
MION94520Medicare ID - Type Unspecified
U77861Medicare UPIN