Healthcare Provider Details

I. General information

NPI: 1265199905
Provider Name (Legal Business Name): MI CHIRO CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2021
Last Update Date: 10/03/2023
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 W GENESEE ST STE 4
FRANKENMUTH MI
48734-1357
US

IV. Provider business mailing address

526 W GENESEE ST STE 2
FRANKENMUTH MI
48734-1357
US

V. Phone/Fax

Practice location:
  • Phone: 989-652-2577
  • Fax: 989-652-4776
Mailing address:
  • Phone: 989-652-2577
  • Fax: 989-652-4776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DENISE HAUBENSTRICKER
Title or Position: FRONT DESK
Credential:
Phone: 989-652-2577