Provider Demographics
NPI:1922371632
Name:LOWELL FAMILY CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:LOWELL FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CHICHESTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:616-293-0385
Mailing Address - Street 1:2531 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49331-8695
Mailing Address - Country:US
Mailing Address - Phone:616-897-8284
Mailing Address - Fax:616-897-6810
Practice Address - Street 1:2531 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MI
Practice Address - Zip Code:49331-8695
Practice Address - Country:US
Practice Address - Phone:616-897-8284
Practice Address - Fax:616-897-6810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009430111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00789737OtherMEDICARE RAILROAD CARRIER
P00789737OtherMEDICARE RAILROAD CARRIER