Provider Demographics
NPI:1194892604
Name:TOWERS CHIROPRACTIC LIFE CENTER PC
Entity type:Organization
Organization Name:TOWERS CHIROPRACTIC LIFE CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:G
Authorized Official - Last Name:TOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:810-687-6100
Mailing Address - Street 1:7487 N CLIO RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:MI
Mailing Address - Zip Code:48458-8227
Mailing Address - Country:US
Mailing Address - Phone:810-687-6100
Mailing Address - Fax:810-687-5541
Practice Address - Street 1:7487 N CLIO RD
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:MI
Practice Address - Zip Code:48458-8227
Practice Address - Country:US
Practice Address - Phone:810-687-6100
Practice Address - Fax:810-687-5541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004122111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B55090OtherBLUE CROSS
MI103142OtherGREAT LAKES HEALTH
MI1407044Medicaid
MI1002105OtherMCLAREN HEALTH ADVANTAGE
MI950B55090OtherHEALTH PLUS OF MI
MI1407044Medicaid
MI0B55090Medicare ID - Type Unspecified