Provider Demographics
NPI:1992230452
Name:ANCHOR CHIROPRACTIC & WELLNESS PLC
Entity type:Organization
Organization Name:ANCHOR CHIROPRACTIC & WELLNESS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:LENGKEEK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:616-510-3869
Mailing Address - Street 1:525 W NORTON AVE
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:49444-3746
Mailing Address - Country:US
Mailing Address - Phone:616-510-3869
Mailing Address - Fax:
Practice Address - Street 1:525 W NORTON AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:49444
Practice Address - Country:US
Practice Address - Phone:616-510-3869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-21
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008930111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI3390Medicare UPIN