Michael C Colgrove, D.C.
Individual provider Active NPI Chiropractor · Centerton, AR
NPI 1326414517 · NPPES record last updated Aug 11, 2015
Key facts
- NPI
- 1326414517
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 16107 (AR)
- Practice address
- 435 W Centerton Blvd
Centerton, AR 72719-8701 - Phone
- (402) 690-2027
- Fax
- (402) 690-2027
- NPI assigned
- Aug 11, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16107 | AR | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complete Chiropractic Solutions | Chiropractor | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 16107 | AR | Yes |
Addresses
Primary practice location
435 W Centerton Blvd
Centerton, AR 72719-8701
Mailing address
411 Beasley Dr
Centerton, AR 72719-9479
Phone (402) 690-2027
Other providers in Centerton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.