VAN BUREN CHIROPRACTIC CLINIC P.C. NPI 1144234451

NPI Information

NPI: 1144234451
Provider Name: VAN BUREN CHIROPRACTIC CLINIC, P.C.
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
309 S KALAMAZOO ST
PAW PAW, MI
ZIP 49079
Phone: (269) 657-7005
Get Directions

VAN BUREN CHIROPRACTIC CLINIC, P.C. is a chiropractor in Paw Paw, MI. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. VAN BUREN CHIROPRACTIC CLINIC, P.C. NPI is 1144234451. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

309 S KALAMAZOO ST
PAW PAW, MI
ZIP 49079-527
Phone: (269) 657-7005
Fax: (269) 657-7007

The provider's authorized official is Raymond Charles Tattersall .
The authorized official title is Owner and has the following contact phone number (269) 657-7005.

The enumeration date for this NPI number is 7/29/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111N00000X	Chiropractor		2301004320	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	16123	OTHER	MICHIGAN	MCARE PIN
2	1935037	MEDICAID	MICHIGAN
3	2301004320	OTHER	MICHIGAN	LICENSE NUMBER
4	P67311	OTHER	MICHIGAN	BLUE CARE NETWORK PIN
5	950H05002	OTHER	MICHIGAN	BCBS MICHIGAN
6	RT004320	OTHER	MICHIGAN	BCBS PIN
7	44-30051	OTHER	MICHIGAN	IBA/PHP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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