Provider Demographics
NPI:1649535006
Name:CHADWELL FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:CHADWELL FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHADWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-362-8991
Mailing Address - Street 1:432 W M 55
Mailing Address - Street 2:
Mailing Address - City:TAWAS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48763-9239
Mailing Address - Country:US
Mailing Address - Phone:989-362-8991
Mailing Address - Fax:989-362-6237
Practice Address - Street 1:432 W M 55
Practice Address - Street 2:
Practice Address - City:TAWAS CITY
Practice Address - State:MI
Practice Address - Zip Code:48763-9239
Practice Address - Country:US
Practice Address - Phone:989-362-8991
Practice Address - Fax:989-362-6237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty