Individual
DR. RAYMOND C TATTERSALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
309 S KALAMAZOO ST, PAW PAW, MI 49079-1527
(269) 657-7005
(269) 657-7007
Mailing address
309 S KALAMAZOO ST, PAW PAW, MI 49079-1527
(269) 657-7005
(269) 657-7007
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301004320
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1935037
—
MI
01
—
2301004320
LICENSE
MA
01
—
95OHO5002
BCBS
MA
Enumeration date
11/02/2006
Last updated
07/08/2007
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