Individual provider · Type 1 NPI
Michael John Modich, DC
Chiropractor · Side Lake, MN
NPI number
1114237013
Active
Practice location
7636 Pine Tree Rd
Side Lake, MN 55781-8441
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor Primary | 111N00000X | 5322 (MN) |
Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
About NPI 1114237013
Michael John Modich, DC's National Provider Identifier is 1114237013, issued on Oct 14, 2010. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Side Lake, MN. The record was last updated on Oct 14, 2010.