Provider Demographics
NPI:1427244680
Name:NASHVILLE & BELLEVUE FAMILY CHIROPRACTIC CENTER INC
Entity type:Organization
Organization Name:NASHVILLE & BELLEVUE FAMILY CHIROPRACTIC CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:NORMAN
Authorized Official - Last Name:CALLTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-852-2070
Mailing Address - Street 1:PO BOX 676
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49073-0676
Mailing Address - Country:US
Mailing Address - Phone:517-852-2070
Mailing Address - Fax:517-852-1979
Practice Address - Street 1:307 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:MI
Practice Address - Zip Code:49073-0676
Practice Address - Country:US
Practice Address - Phone:517-852-2070
Practice Address - Fax:517-852-1979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMC005548111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2691007Medicaid
MI0N95740Medicare PIN