Provider Demographics
NPI:1174727341
Name:JOHN F SMARCH DC PC
Entity type:Organization
Organization Name:JOHN F SMARCH DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:KEEZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-787-4513
Mailing Address - Street 1:300 W WASHINGTON AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-2175
Mailing Address - Country:US
Mailing Address - Phone:517-787-4513
Mailing Address - Fax:517-787-6943
Practice Address - Street 1:300 W WASHINGTON AVE STE 150
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-2175
Practice Address - Country:US
Practice Address - Phone:517-787-4513
Practice Address - Fax:517-787-6943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJS007229111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00229475OtherRAILROAD MEDICARE
MI950C811280OtherBLUE CROSS BLUE SHEILD
MIP00229475OtherRAILROAD MEDICARE
MIU60575Medicare UPIN