Provider Demographics
NPI:1932236270
Name:MCBAIN FAMILY CHIROPRACTIC CENTER P.C.
Entity Type:Organization
Organization Name:MCBAIN FAMILY CHIROPRACTIC CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:GISCHIA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:231-825-8143
Mailing Address - Street 1:100 N ROLAND ST
Mailing Address - Street 2:PO BOX 207
Mailing Address - City:MC BAIN
Mailing Address - State:MI
Mailing Address - Zip Code:49657-9683
Mailing Address - Country:US
Mailing Address - Phone:231-825-8143
Mailing Address - Fax:231-285-0536
Practice Address - Street 1:100 N ROLAND ST
Practice Address - Street 2:
Practice Address - City:MC BAIN
Practice Address - State:MI
Practice Address - Zip Code:49657-9683
Practice Address - Country:US
Practice Address - Phone:231-825-8143
Practice Address - Fax:231-825-0536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJG006101111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP25758FOtherBCN-SE
GAP00040617OtherPALMETTO RAILROAD
MI104181OtherPREFERRED CHOICES
MIU47993Medicare UPIN
MIOE75267Medicare ID - Type Unspecified