Healthcare Provider Details

I. General information

NPI: 1033145842
Provider Name (Legal Business Name): CHERIE A MCKENZIE DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 03/27/2020
Certification Date: 03/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1554 N ABBE RD
FAIRVIEW MI
48621-8719
US

IV. Provider business mailing address

1554 N ABBE RD
FAIRVIEW MI
48621-8719
US

V. Phone/Fax

Practice location:
  • Phone: 989-848-2265
  • Fax: 989-305-6419
Mailing address:
  • Phone: 989-848-2265
  • Fax: 989-848-8003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number006520
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: