Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 2301004635 | MI |
NPI | 1235347337 |
---|---|
Provider Name | Dr. Donald E Joffrion |
First Address | Otsego, MI 49078-9643 |
Second Address | Otsego, MI 49078-9643 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2007 |
Last Update Date | 03/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
950Z350130 | BLUE CROSS BLUE SHIELD (01) | MI |
T33878 | (02) | MI |