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General NPI Number Information
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NPI Number | 1891989950
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Entity Type | Organization
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Legal Business Name | MAIS CHIROPRACTIC CLINIC, PC
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Dates
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Enumeration Date | 08/31/2007
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Last Update Date | 11/08/2012
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Provider Practice Location Address
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Address Line | 115 S. GRAND AVE.
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City | SCHOOLCRAFT
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State | MI
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Zip | 49087-0337
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Country | US
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Telephone | 269-679-5530
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Fax | 269-679-5530
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Provider Business Mailing Address
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Address Line | PO BOX 337 115 S. GRAND
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City | SCHOOLCRAFT
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State | MI
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Zip | 49087-0337
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Country | US
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Telephone | 269-679-5530
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Fax | 269-679-5530
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Authorized Official
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Title or Position | PRESIDENT
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Name | SCOTT ANTHONY MAIS
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Credential | D.C.
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Telephone | 269-679-5530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301005565
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License Number State | MI
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