Organization
MAYNARD CHIROPRACTIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN EMERY MAYNARD DC (SOLE MEMBER)
(269) 983-2292
Entity
Organization
Contact information
Practice address
2934 NILES AVE, SAINT JOSEPH, MI 49085-2418
(269) 983-2292
(269) 983-6155
Mailing address
2934 NILES AVE, SAINT JOSEPH, MI 49085-2418
(269) 983-2292
(269) 983-6155
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301006933
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A10068
BCBSMI
MI
01
—
1619035474
PROVIDER NPI
MI
01
—
OA15091
MEDICARE
MI
Enumeration date
06/27/2012
Last updated
06/27/2012
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