Provider Demographics
NPI:1730412115
Name:GIGANTE CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:GIGANTE CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:LUKE
Authorized Official - Last Name:GIGANTE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-726-1144
Mailing Address - Street 1:49101 SCHOENHERR RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-3881
Mailing Address - Country:US
Mailing Address - Phone:586-726-1144
Mailing Address - Fax:586-726-1446
Practice Address - Street 1:49101 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48315-3881
Practice Address - Country:US
Practice Address - Phone:586-726-1144
Practice Address - Fax:586-726-1446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-16
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005639111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E05137Medicare UPIN