=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447466271
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HUGHES COMPREHENSIVE CHIROPRACTIC CLINIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/16/2007
-----------------------------------------------------
Last Update Date | 07/10/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 610 W MICHIGAN AVE
-----------------------------------------------------
City | JACKSON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49201-1907
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-784-9101
-----------------------------------------------------
Fax | 517-784-9103
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 610 W MICHIGAN AVE
-----------------------------------------------------
City | JACKSON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49201-1907
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-784-9101
-----------------------------------------------------
Fax | 517-784-9103
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIROPRACTOR
-----------------------------------------------------
Name | DR. MICHAEL HUGHES
-----------------------------------------------------
Credential | D.O.
-----------------------------------------------------
Telephone | 517-784-9101
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2301002962
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------