Provider Demographics
NPI:1588767156
Name:WAVERLY CHIROPRACTIC CENTER P.L.L.C.
Entity type:Organization
Organization Name:WAVERLY CHIROPRACTIC CENTER P.L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SETTIMI
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:517-394-3353
Mailing Address - Street 1:5021 W. SAINT JOSEPH HWY SUITE 1
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917
Mailing Address - Country:US
Mailing Address - Phone:517-394-3353
Mailing Address - Fax:517-394-2723
Practice Address - Street 1:5021 W. SAINT JOSEPH HWY SUITE 1
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917
Practice Address - Country:US
Practice Address - Phone:517-394-3353
Practice Address - Fax:517-394-2723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
950B310460OtherBCBS
ON63590Medicare ID - Type Unspecified