Healthcare Provider Details

I. General information

NPI: 1104069327
Provider Name (Legal Business Name): ABRAHAM JOHN DEMOND DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2009
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E CHICAGO RD
COLDWATER MI
49036-8130
US

IV. Provider business mailing address

1170 W MICHIGAN AVE
MARSHALL MI
49068-1497
US

V. Phone/Fax

Practice location:
  • Phone: 517-278-7246
  • Fax:
Mailing address:
  • Phone: 269-781-7000
  • Fax: 269-781-2522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301009483
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: