Provider Demographics
NPI:1154779643
Name:STILLPOINT CHIROPRACTIC CENTRE PLLC
Entity type:Organization
Organization Name:STILLPOINT CHIROPRACTIC CENTRE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GEN PTR
Authorized Official - Prefix:DR
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:SKINDZIER
Authorized Official - Last Name:GLEISS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:269-637-2131
Mailing Address - Street 1:PO BOX 989
Mailing Address - Street 2:
Mailing Address - City:SOUTH HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49090-0989
Mailing Address - Country:US
Mailing Address - Phone:269-468-4309
Mailing Address - Fax:269-639-8888
Practice Address - Street 1:888 PHILLIPS ST
Practice Address - Street 2:
Practice Address - City:SOUTH HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49090-1845
Practice Address - Country:US
Practice Address - Phone:269-637-2131
Practice Address - Fax:269-639-8888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005679111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty