Provider Demographics
NPI:1215460852
Name:EXPLORE CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:EXPLORE CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:REVORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-372-0003
Mailing Address - Street 1:913 E PICKARD ST
Mailing Address - Street 2:SUITE N
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-1095
Mailing Address - Country:US
Mailing Address - Phone:989-372-0003
Mailing Address - Fax:989-393-6009
Practice Address - Street 1:913 E PICKARD ST
Practice Address - Street 2:SUITE N
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-1095
Practice Address - Country:US
Practice Address - Phone:989-372-0003
Practice Address - Fax:989-393-6009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010537111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty