MEDICARE: STILLPOINT CHIROPRACTIC CENTRE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2301005679	MI

General Provider Information

NPI Number	:	1154779643
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STILLPOINT CHIROPRACTIC CENTRE PLLC

Provider Business Mailing Address
First Line	:	PO BOX 989
Second Line	:
City	:	SOUTH HAVEN
State	:	MI
Zip	:	49090-0989
Country	:	US
Telephone Number	:	269-468-4309
Fax Number	:	269-639-8888

Provider Business Practice Location Address
First Line	:	888 PHILLIPS ST
Second Line	:
City	:	SOUTH HAVEN
State	:	MI
Zip	:	49090-1845
Country	:	US
Telephone Number	:	269-637-2131
Fax Number	:	269-639-8888

Authorized Official
Title or Position	:	GEN PTR
Name	:	DR. MELANIE SKINDZIER GLEISS
Credential	:	DC
Telephone Number	:	269-637-2131

Provider Enumeration Date	:	05/25/2016
Last Update Date	:	05/25/2016

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