MEDICARE: BOYNE VALLEY CHIROPRACTIC AND WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1588520639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOYNE VALLEY CHIROPRACTIC AND WELLNESS

Provider Business Mailing Address
First Line	:	430 BOYNE AVE UNIT 1
Second Line	:
City	:	BOYNE CITY
State	:	MI
Zip	:	49712-1263
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	430 BOYNE AVE UNIT 1
Second Line	:
City	:	BOYNE CITY
State	:	MI
Zip	:	49712-1263
Country	:	US
Telephone Number	:	231-675-1593
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	COREY REDMAN
Credential	:	DC
Telephone Number	:	231-675-1593

Provider Enumeration Date	:	01/02/2026
Last Update Date	:	01/09/2026

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