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NPI Code Detail

MEDICARE: MCCULLOUGH FAMILY CHIROPRACTIC, P.C.

MEDICARE: MCCULLOUGH FAMILY CHIROPRACTIC, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorMM007869MI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DB4802OTHERMIMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1950A311080OTHERBCBS OF MICHIGAN

General Provider Information

NPI Number : 1255511200
Entity Type Code : Organization
Provider Name (Legal Business Name) : MCCULLOUGH FAMILY CHIROPRACTIC, P.C.
Provider Business Mailing Address
First Line : 1346 COLUMBIA AVE W
Second Line : SUITE 101
City : BATTLE CREEK
State : MI
Zip : 49015-3067
Country : US
Telephone Number : 269-964-3300
Fax Number : 269-964-3366
Provider Business Practice Location Address
First Line : 1346 COLUMBIA AVE W
Second Line : SUITE 101
City : BATTLE CREEK
State : MI
Zip : 49015-3067
Country : US
Telephone Number : 269-964-3300
Fax Number : 269-964-3366
Authorized Official
Title or Position : CHIROPRACTOR/OWNER
Name : DR. MARK E MCCULLOUGH
Credential : D.C.
Telephone Number : 269-964-3300
Provider Enumeration Date : 11/07/2007
Last Update Date : 10/30/2012

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Directions to “MCCULLOUGH FAMILY CHIROPRACTIC, P.C. ” Practice Location

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