Provider Demographics
NPI:1053558031
Name:CHICHESTER, MARIA A (DC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:CHICHESTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9090 S RODGERS CT SE STE E
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-8052
Mailing Address - Country:US
Mailing Address - Phone:616-891-8153
Mailing Address - Fax:616-891-0060
Practice Address - Street 1:9090 S RODGERS CT SE STE E
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316-8052
Practice Address - Country:US
Practice Address - Phone:616-891-8153
Practice Address - Fax:616-891-0060
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009475111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor