Healthcare Provider Details

I. General information

NPI: 1053648527
Provider Name (Legal Business Name): ALL NATURAL CHIROPRACTIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2009
Last Update Date: 02/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7388 FENTON RD
GRAND BLANC MI
48439-8963
US

IV. Provider business mailing address

7388 FENTON RD
GRAND BLANC MI
48439-8963
US

V. Phone/Fax

Practice location:
  • Phone: 616-916-1616
  • Fax:
Mailing address:
  • Phone: 616-916-1616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberDC002969L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberDC002969L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH030108
License Number StateDC
# 4
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301009510
License Number StateMI

VIII. Authorized Official

Name: LINDA SOLOMON
Title or Position: OWNER
Credential: DC
Phone: 616-916-1616