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Organization

AUSABLE CHIROPRACTIC CLINIC, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KIMBERLY S HUNTER D.C. (OWNER/MEMBER)
(989) 826-3333
Entity
Organization

Contact information

Practice address
200 S DEYARMOND ST, MIO, MI 48647-9108
(989) 329-9733
Mailing address
PO BOX 426, MIO, MI 48647-0426
(989) 826-3333
(989) 826-3332

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301009407
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0P53580
MEDICARE PTAN
MI
01
95-0-F8-0252-0
BCBS
MI
01
P53580001
MEDICARE (INDIVIDUAL) PTAN
MI
Enumeration date
01/09/2008
Last updated
12/08/2008
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