=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356712111
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMILY KATHRYN EILERS D.C.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/19/2015
-----------------------------------------------------
Last Update Date | 10/19/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 52 PALCICH RD
-----------------------------------------------------
City | FRANKFORT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49635-9602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 231-352-4447
-----------------------------------------------------
Fax | 231-352-4225
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4624 RICE RD
-----------------------------------------------------
City | BENZONIA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49616-9721
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 231-383-1820
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2301010375
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------