Healthcare Provider Details

I. General information

NPI: 1114907342
Provider Name (Legal Business Name): DAVIN ANDREW ISAACSON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 07/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E QUINCY ST SUITE 3
HANCOCK MI
49930-2167
US

IV. Provider business mailing address

101 E QUINCY ST STE 3
HANCOCK MI
49930-2167
US

V. Phone/Fax

Practice location:
  • Phone: 906-482-4900
  • Fax: 906-482-0601
Mailing address:
  • Phone: 906-482-4900
  • Fax: 906-482-0601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301009078
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: