Provider Demographics
NPI:1245388453
Name:MILLINGTON CHIROPRACTIC CENTER, INC.
Entity type:Organization
Organization Name:MILLINGTON CHIROPRACTIC CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:DANSHINHEE
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-871-4733
Mailing Address - Street 1:8758 STATE RD
Mailing Address - Street 2:
Mailing Address - City:MILLINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48746-9665
Mailing Address - Country:US
Mailing Address - Phone:989-871-4733
Mailing Address - Fax:989-871-4572
Practice Address - Street 1:8758 STATE RD
Practice Address - Street 2:
Practice Address - City:MILLINGTON
Practice Address - State:MI
Practice Address - Zip Code:48746-9665
Practice Address - Country:US
Practice Address - Phone:989-871-4733
Practice Address - Fax:989-871-4572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008698111N00000X
MI2301008559111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN80490001Medicare ID - Type UnspecifiedDR. KEVIN SUTTON
MIN80490002Medicare ID - Type UnspecifiedDR. MISTY SUTTON
MIU97640Medicare UPIN
MIU97641Medicare UPIN
MION80490Medicare ID - Type UnspecifiedMILLINGTON CHIROPRACTIC C