Healthcare Provider Details

I. General information

NPI: 1750447041
Provider Name (Legal Business Name): CHAPPELL CHIROPRACTIC WELLNESS CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 04/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3875 M72 EAST
ACME MI
49610
US

IV. Provider business mailing address

PO BOX 1649
ACME MI
49610-1649
US

V. Phone/Fax

Practice location:
  • Phone: 231-938-3830
  • Fax: 231-938-3831
Mailing address:
  • Phone: 231-938-3830
  • Fax: 231-938-3831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberGC007695
License Number StateMI

VIII. Authorized Official

Name: MRS. LYN CHAPPELL
Title or Position: SECRETARY
Credential:
Phone: 231-938-3830