Martin L Cousineau, DC
Individual provider Active NPI Chiropractor · Clio, MI
NPI 1699980185 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1699980185
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2837 (MI)
- Practice address
- 143 W Vienna St
Clio, MI 48420-1333 - Phone
- (810) 686-7770
- Fax
- (810) 686-7776
- NPI assigned
- May 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
143 W Vienna St
Clio, MI 48420-1333
Phone (810) 686-7770
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080612000600 | MI | Practitioner - Chiropractic | 9335210772 | Practice locations: Clio, MI |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2837 | MI | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2837 | MI | Yes |
Addresses
Primary practice location
143 W Vienna St
Clio, MI 48420-1333
Mailing address
143 W Vienna St
Clio, MI 48420-1333
Phone (810) 686-7770
Other providers in Clio, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.