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General NPI Number Information
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NPI Number | 1316218597
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Entity Type | Organization
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Legal Business Name | T.J. NUGENT D.C., P.L.C.
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Dates
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Enumeration Date | 01/20/2012
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Last Update Date | 01/20/2012
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Provider Practice Location Address
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Address Line | 2931 MANOR DR
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City | MIDLAND
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State | MI
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Zip | 48640-4476
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Country | US
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Telephone | 989-835-8330
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Fax | 989-835-4906
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Provider Business Mailing Address
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Address Line | 2931 MANOR DR
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City | MIDLAND
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State | MI
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Zip | 48640-4476
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Country | US
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Telephone | 989-835-8330
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Fax | 989-835-4906
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. T.J. NUGENT
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Credential | D.C.
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Telephone | 989-835-8330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 2301005042
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License Number State | MI
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