Healthcare Provider Details

I. General information

NPI: 1982692638
Provider Name (Legal Business Name): MICHAEL A. REMMICK D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 06/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 6TH AVE NE
DEVILS LAKE ND
58301-3025
US

IV. Provider business mailing address

201 6TH AVE NE
DEVILS LAKE ND
58301-3025
US

V. Phone/Fax

Practice location:
  • Phone: 701-662-7538
  • Fax: 701-662-5025
Mailing address:
  • Phone: 701-662-7538
  • Fax: 701-662-5025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number396
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: