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NPI Code Detail

MEDICARE: GARY MCGINNIS D.C.

MEDICARE:   GARY  MCGINNIS  D.C.
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
1111N00000XChiropractor2301004283MI

General Provider Information

NPI Number : 1376619049
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY MCGINNIS D.C.
Provider Business Mailing Address
First Line : 3825 24TH AVE
Second Line :
City : FORT GRATIOT
State : MI
Zip : 48059-4100
Country : US
Telephone Number : 810-982-6115
Fax Number :
Provider Business Practice Location Address
First Line : 3825 24TH AVE
Second Line :
City : FORT GRATIOT
State : MI
Zip : 48059-4100
Country : US
Telephone Number : 810-982-6115
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2006
Last Update Date : 11/06/2007

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