Provider Demographics
NPI:1043764558
Name:DAWSON FAMILY CHIROPRACTIC PRACTICE
Entity type:Organization
Organization Name:DAWSON FAMILY CHIROPRACTIC PRACTICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:269-781-7000
Mailing Address - Street 1:1170 W MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-8545
Mailing Address - Country:US
Mailing Address - Phone:269-781-7000
Mailing Address - Fax:269-781-2522
Practice Address - Street 1:1170 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-8545
Practice Address - Country:US
Practice Address - Phone:269-781-7000
Practice Address - Fax:269-781-2522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty