MEDICARE: ATKINSON CLINIC OF CHIROPRACTIC

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	2301006610	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	95OH16313	OTHER	MI	BLUE CROSS BS OF MI

General Provider Information

NPI Number	:	1740246842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATKINSON CLINIC OF CHIROPRACTIC

Provider Business Mailing Address
First Line	:	7970 CLARK LAKE RD
Second Line	:
City	:	CHELSEA
State	:	MI
Zip	:	48118
Country	:	US
Telephone Number	:	734-475-8669
Fax Number	:	734-475-0304

Provider Business Practice Location Address
First Line	:	7970 CLARK LAKE RD
Second Line	:
City	:	CHELSEA
State	:	MI
Zip	:	48118
Country	:	US
Telephone Number	:	734-475-8669
Fax Number	:	734-475-0304

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. LETHA M ATKINSON
Credential	:
Telephone Number	:	734-475-8669

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	08/22/2020

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