Provider Demographics
NPI:1801029244
Name:DEAN A FLORA DC PC
Entity type:Organization
Organization Name:DEAN A FLORA DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:FLORA
Authorized Official - Suffix:
Authorized Official - Credentials:DC PC
Authorized Official - Phone:989-791-1110
Mailing Address - Street 1:6320 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-3481
Mailing Address - Country:US
Mailing Address - Phone:989-791-1110
Mailing Address - Fax:989-791-1194
Practice Address - Street 1:6320 STATE ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-3481
Practice Address - Country:US
Practice Address - Phone:989-791-1110
Practice Address - Fax:989-791-1194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIT33547Medicare UPIN