Healthcare Provider Details

I. General information

NPI: 1346328986
Provider Name (Legal Business Name): HILLSDALE CHIROPRACTIC CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 06/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 OLDS ST
JONESVILLE MI
49250-9477
US

IV. Provider business mailing address

735 OLDS ST
JONESVILLE MI
49250-9477
US

V. Phone/Fax

Practice location:
  • Phone: 517-849-0000
  • Fax: 517-849-2631
Mailing address:
  • Phone: 517-849-0000
  • Fax: 517-849-2631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PEGGY ANN STJOHN
Title or Position: OFFICE MANAGER
Credential:
Phone: 517-849-0000