Upston Chiropractic Wellness Center, PLLC
Organization Active NPI Chiropractor · Kalamazoo, MI
NPI 1275826596 · NPPES record last updated May 19, 2011
Key facts
- NPI
- 1275826596
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2301009745 (MI)
- Legal business name
- UPSTON CHIROPRACTIC WELLNESS CENTER, PLLC
- Practice address
- 4200 W Michigan Ave
Ste 231
Kalamazoo, MI 49006-5892 - Phone
- (269) 569-5621
- NPI assigned
- May 19, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. Blake Cable Upston, D.C.
- Title
- Owner
- Phone
- (269) 569-5621
Practitioners 2
-
Kali Edwards, D.C.
-
Blake Cable Upston, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110620000387 | MI | Part B Supplier - Clinic/Group Practice | 4587842687 |
Receives reassigned benefits from 2 practitioners Practice locations: Kalamazoo, MI |
National Provider Directory
Locations
4200 W Michigan Ave
Ste 231
Kalamazoo, MI 49006
Phone (269) 569-5621
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 2301009745 | MI | Yes |
Addresses
Primary practice location
4200 W Michigan Ave
Ste 231
Kalamazoo, MI 49006-5892
Mailing address
4200 W Michigan Ave
Ste 231
Kalamazoo, MI 49006-5892
Phone (269) 569-5621
Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.