Centofanti Chiropractic Center, PC
Organization Active NPI Chiropractor · Marlette, MI
NPI 1629347232 · NPPES record last updated Jun 22, 2015
Key facts
- NPI
- 1629347232
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- CENTOFANTI CHIROPRACTIC CENTER, PC
- Practice address
- 3085 Main St
Marlette, MI 48453-1243 - Phone
- (989) 635-3828
- NPI assigned
- Dec 28, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. Ernest Richard Centofanti, D.C., C.C.S.P.
- Title
- President
- Phone
- (989) 635-3828
Practitioners 3
-
Ernest Richard Centofanti, D.C., C.C.S.P.
-
Gena M Daniels, LMT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120821000060 | MI | Part B Supplier - Clinic/Group Practice | 5597912949 |
Receives reassigned benefits from 1 practitioner Practice locations: Imlay City, MI; Marlette, MI |
National Provider Directory
Locations
3085 Main St
Marlette, MI 48453
Phone (989) 635-3828
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes | ||
| Clinic/Center | 261Q00000X | 2301005491 | MI |
Addresses
Primary practice location
3085 Main St
Marlette, MI 48453-1243
Mailing address
3085 Main St
PO Box 245
Marlette, MI 48453-1243
Phone (989) 635-3828
Other providers in Marlette, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2015. 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.