| Waters Edge Chiropractic Plc | |
|
922 Delta Ave Gladstone MI 49837-1649 | |
| (906) 428-9076 | |
| Not Available |
| Full Name | Waters Edge Chiropractic Plc |
|---|---|
| Speciality | Clinic/Center |
| Location | 922 Delta Ave, Gladstone, Michigan |
| Authorized Official Name and Position | Patrick Dean Johnson (CEO) |
| Authorized Official Contact | 9063992800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waters Edge Chiropractic Plc 1010 Delta Ave Ste 216 Gladstone MI 49837-1522 Ph: (906) 428-9076 | Waters Edge Chiropractic Plc 922 Delta Ave Gladstone MI 49837-1649 Ph: (906) 428-9076 |
| NPI Number | 1396916482 |
|---|---|
| Provider Enumeration Date | 03/17/2008 |
| Last Update Date | 03/17/2021 |
| Medicare PECOS PAC ID | 9032285804 |
|---|---|
| Medicare Enrollment ID | O20080905000630 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396916482 | NPI | - | NPPES |
| 1200009 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2301009453 (Michigan) | Primary |
| Provider Name | Patrick D Johnson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1467626853 PECOS PAC ID: 8628144490 Enrollment ID: I20080905000628 |
Marquette General Medical Clinic - Gladstone Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2002 Minneapolis Ave, Gladstone, MI 49837 Phone: 906-428-1856 Fax: 906-728-1960 | |
St Francis Hospital - Gladstone Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 145 4th Avenue N, Gladstone, MI 49837 Phone: 906-428-3273 |