Provider Demographics
NPI:1841468618
Name:BPDC, PC
Entity type:Organization
Organization Name:BPDC, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:PICHE'
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:231-922-0110
Mailing Address - Street 1:551 S GARFIELD AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-3482
Mailing Address - Country:US
Mailing Address - Phone:231-922-0110
Mailing Address - Fax:231-922-0182
Practice Address - Street 1:551 S GARFIELD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-3482
Practice Address - Country:US
Practice Address - Phone:231-922-0110
Practice Address - Fax:231-922-0182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty