Provider Demographics
NPI:1154348183
Name:HARBOR VIEW CHIROPRACTIC PC
Entity type:Organization
Organization Name:HARBOR VIEW CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:KLUMPP
Authorized Official - Suffix:SR
Authorized Official - Credentials:DC
Authorized Official - Phone:906-228-2434
Mailing Address - Street 1:1202 SOUTH FRONT STREET
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855
Mailing Address - Country:US
Mailing Address - Phone:906-228-2434
Mailing Address - Fax:906-228-2446
Practice Address - Street 1:1202 SOUTH FRONT STREET
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855
Practice Address - Country:US
Practice Address - Phone:906-228-2434
Practice Address - Fax:906-228-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008874111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00305960OtherRAILROAD MEDICARE PIN NUM
V02006Medicare UPIN
MI0P30020Medicare ID - Type Unspecified