Provider Demographics
NPI:1902950090
Name:KINTIGH, ROBERT L (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:KINTIGH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 W MAIN ST
Mailing Address - Street 2:P.O. BOX 375
Mailing Address - City:SPRING ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49283-9618
Mailing Address - Country:US
Mailing Address - Phone:517-750-9150
Mailing Address - Fax:
Practice Address - Street 1:233 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRING ARBOR
Practice Address - State:MI
Practice Address - Zip Code:49283-9618
Practice Address - Country:US
Practice Address - Phone:517-750-9150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004859111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1549854Medicaid
MIRK004859OtherBCBS
MIRK004859OtherBCBS
MI1549854Medicaid