Healthcare Provider Details

I. General information

NPI: 1548487168
Provider Name (Legal Business Name): BRIDGMAN CHIROPRACTORS. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 03/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 RED ARROW HWY.
BRIDGMAN MI
49106-0326
US

IV. Provider business mailing address

9500 RED ARROW HWY.
BRIDGMAN MI
49106-0326
US

V. Phone/Fax

Practice location:
  • Phone: 269-465-6757
  • Fax: 269-466-5202
Mailing address:
  • Phone: 269-465-6757
  • Fax: 269-466-5202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301006132
License Number StateMI

VIII. Authorized Official

Name: DR. GEORGE ALVIN MASSEY
Title or Position: PRESIDENT
Credential: D.C.
Phone: 269-465-6757