Provider Demographics
NPI:1366916777
Name:NORTH STAR FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:NORTH STAR FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:K
Authorized Official - Last Name:EILERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:231-383-1820
Mailing Address - Street 1:218 7TH ST
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:MI
Mailing Address - Zip Code:49635-9055
Mailing Address - Country:US
Mailing Address - Phone:231-871-0191
Mailing Address - Fax:844-632-8256
Practice Address - Street 1:218 7TH ST
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:MI
Practice Address - Zip Code:49635-9055
Practice Address - Country:US
Practice Address - Phone:231-871-0191
Practice Address - Fax:844-632-8256
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH STAR FAMILY CHIROPRACTIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-18
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty