Provider Demographics
NPI:1841360419
Name:MICHEL, MICHAEL G (BS, DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:G
Last Name:MICHEL
Suffix:
Gender:M
Credentials:BS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 BIG BEND RD
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-2813
Mailing Address - Country:US
Mailing Address - Phone:573-776-1111
Mailing Address - Fax:573-785-3101
Practice Address - Street 1:1925 BIG BEND RD
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-2813
Practice Address - Country:US
Practice Address - Phone:573-776-1111
Practice Address - Fax:573-785-3101
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1999135688111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor