Individual
PHILLIP LANGE CHADWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
PC007008
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3083544
—
MI
01
—
950E60108
BCBSM
MI
Enumeration date
09/24/2007
Last updated
04/27/2018
Update your record
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