Provider Demographics
NPI:1427476688
Name:HURTUBISE, SERGE CHRISTIAN (DC)
Entity type:Individual
Prefix:
First Name:SERGE
Middle Name:CHRISTIAN
Last Name:HURTUBISE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48838-2619
Mailing Address - Country:US
Mailing Address - Phone:616-232-4027
Mailing Address - Fax:
Practice Address - Street 1:1712 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MI
Practice Address - Zip Code:48838-2619
Practice Address - Country:US
Practice Address - Phone:616-232-4027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL181829111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor