Organization
EDGERTON CHIROPRACTIC CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT LEE EDGERTON DC (PRESIDENT)
(810) 387-3342
Entity
Organization
Contact information
Practice address
7616 BROCKWAY RD, BROCKWAY, MI 48097-3408
(810) 387-3342
(810) 387-3543
Mailing address
7616 BROCKWAY RD, BROCKWAY, MI 48097-3408
(810) 387-3342
(810) 387-3543
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
BE006504
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
950G411160
BCBS
MI
Enumeration date
10/05/2006
Last updated
06/16/2014
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