Healthcare Provider Details

I. General information

NPI: 1063324655
Provider Name (Legal Business Name): BLACK RIVER CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5055 F 41
BLACK RIVER MI
48721-9722
US

IV. Provider business mailing address

5055 F 41
BLACK RIVER MI
48721-9722
US

V. Phone/Fax

Practice location:
  • Phone: 248-894-1659
  • Fax:
Mailing address:
  • Phone: 248-894-1659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. BERNARD RUMPH
Title or Position: DC/PRESIDENT
Credential: DC
Phone: 248-894-1659