Burcon, Michael T
Burcon, Michael T is an sole proprietor health care provider with primary practice located at 3501 Lake Eastbrook Blvd Se Suite 252, Grand Rapids MI 49546-5938. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Burcon, Michael T can be contacted via phone (616) 575-9990.Contact Information
Primary practice address
3501 Lake Eastbrook Blvd Se Suite 252
Grand Rapids MI 49546-5938
Phone: (616) 575-9990
Fax: (616) 575-9995
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 2301007711 | Michigan |
Profile Details
| NPI number | 1992702542 |
|---|---|
| LBN Legal business name | Burcon, Michael T |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 28th, 2005 |
| Last updated | Mar 25th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992702542 | NPPES |
| Michigan | Other | 950D151480 | BLUE CROSS |
| Michigan | MEDICAID | 4126753 | BLUE CROSS |
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