Provider Demographics
NPI:1952550170
Name:DISCOVER CHIROPRACTIC U.P., PLLC
Entity Type:Organization
Organization Name:DISCOVER CHIROPRACTIC U.P., PLLC
Other - Org Name:DAVIN ISAACSON, SOLE MEMBER
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVIN
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:ISAACSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:906-482-4900
Mailing Address - Street 1:101 E QUINCY ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HANCOCK
Mailing Address - State:MI
Mailing Address - Zip Code:49930-2167
Mailing Address - Country:US
Mailing Address - Phone:906-482-4900
Mailing Address - Fax:906-482-0601
Practice Address - Street 1:101 E QUINCY ST
Practice Address - Street 2:SUITE 3
Practice Address - City:HANCOCK
Practice Address - State:MI
Practice Address - Zip Code:49930-2167
Practice Address - Country:US
Practice Address - Phone:906-482-4900
Practice Address - Fax:906-482-0601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009078111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950C110430OtherBCBS
MI950C110310OtherBCBS
MI950C110430OtherBCBS
0P40460Medicare PIN