Organization
MATTAWAN CHIROPRACTIC CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAYLA RANGER-DEAN D.C. (PRESIDENT)
(269) 668-4521
Entity
Organization
Contact information
Practice address
55475 N MAIN ST, MATTAWAN, MI 49071-8304
(269) 668-4521
(269) 668-4522
Mailing address
55475 N MAIN ST, MATTAWAN, MI 49071-8304
(269) 668-4521
(269) 668-4522
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
KR005892
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2892570
—
MI
01
—
4051784
BCBS OF IL
IL
01
—
44-30154
IBA-UNITED HEALTH CARE
MI
01
—
950H05015
BCBS OF MI
MI
Enumeration date
09/13/2006
Last updated
08/22/2020
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