Provider Demographics
NPI:1215280862
Name:SAUGATUCK CHIROPRACTIC CLINIC, LLC
Entity type:Organization
Organization Name:SAUGATUCK CHIROPRACTIC CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:DUANE
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:269-857-1900
Mailing Address - Street 1:3219 BLUE STAR HWY
Mailing Address - Street 2:200
Mailing Address - City:SAUGATUCK
Mailing Address - State:MI
Mailing Address - Zip Code:49453-9786
Mailing Address - Country:US
Mailing Address - Phone:269-857-1900
Mailing Address - Fax:269-857-1900
Practice Address - Street 1:3219 BLUE STAR HWY
Practice Address - Street 2:200
Practice Address - City:SAUGATUCK
Practice Address - State:MI
Practice Address - Zip Code:49453-9786
Practice Address - Country:US
Practice Address - Phone:269-857-1900
Practice Address - Fax:269-857-1900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009993111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL67530Medicare UPIN