Provider Demographics
NPI:1033145842
Name:MCKENZIE, CHERIE A (DC)
Entity type:Individual
Prefix:DR
First Name:CHERIE
Middle Name:A
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1554 N ABBE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48621-8719
Mailing Address - Country:US
Mailing Address - Phone:989-848-2265
Mailing Address - Fax:989-848-8003
Practice Address - Street 1:1554 N ABBE RD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:MI
Practice Address - Zip Code:48621-8719
Practice Address - Country:US
Practice Address - Phone:989-848-2265
Practice Address - Fax:989-305-6419
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI006520111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4391387Medicaid
MA0F85023OtherBCBSM
MIT33493Medicare UPIN
MA0F85023OtherBCBSM