Healthcare Provider Details

I. General information

NPI: 1346013315
Provider Name (Legal Business Name): 906 CHIROPRACTIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2023
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13894 US HIGHWAY 45
BRUCE CROSSING MI
49912
US

IV. Provider business mailing address

16620 NOVAK RD
EWEN MI
49925-9011
US

V. Phone/Fax

Practice location:
  • Phone: 906-458-1437
  • Fax:
Mailing address:
  • Phone: 906-458-1437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TONI PASTOTNIK
Title or Position: CHIROPRACTOR/MEMBER
Credential: DC
Phone: 906-458-1437