Provider Demographics
NPI:1649444126
Name:PAQUIN CHIROPRACTIC P.C.
Entity type:Organization
Organization Name:PAQUIN CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:PAQUIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:734-944-8484
Mailing Address - Street 1:144 S INDUSTRIAL DR
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-9493
Mailing Address - Country:US
Mailing Address - Phone:734-944-8484
Mailing Address - Fax:734-944-8686
Practice Address - Street 1:144 S INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-9493
Practice Address - Country:US
Practice Address - Phone:734-944-8484
Practice Address - Fax:734-944-8686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MITP007301111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI95-0H11245-0OtherBC/BSM PROVIDER
MITP007301OtherSTATE LICENCE NUMBER
N90410003OtherCOMMON PROVIDER NUMBER
MITP007301OtherSTATE LICENCE NUMBER
MI95-0H11245-0OtherBC/BSM PROVIDER
MI0N90410Medicare PIN