Healthcare Provider Details

I. General information

NPI: 1841235694
Provider Name (Legal Business Name): GATEWAY FAMILY CHIROPRACTIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 PALCICH RD
FRANKFORT MI
49635-9602
US

IV. Provider business mailing address

52 PALCICH RD PO BOX 1731
FRANKFORT MI
49635-9602
US

V. Phone/Fax

Practice location:
  • Phone: 231-352-4447
  • Fax: 231-325-2279
Mailing address:
  • Phone: 231-352-4447
  • Fax: 231-325-2279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301006813
License Number StateMI

VIII. Authorized Official

Name: DR. DARREN R LACHARITE
Title or Position: PRESIDENT
Credential: DC
Phone: 231-352-4447