Healthcare Provider Details
I. General information
NPI: 1568401974
Provider Name (Legal Business Name): DENHOLM FAMILY CHIROPRACTIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6838 M 93 HWY S
GRAYLING MI
49738-7766
US
IV. Provider business mailing address
6838 M 93 HWY S
GRAYLING MI
49738-7766
US
V. Phone/Fax
- Phone: 989-348-6600
- Fax: 989-348-3537
- Phone: 989-348-6600
- Fax: 989-348-3537
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | CD005021 |
| License Number State | MI |
VIII. Authorized Official
Name: DR.
CRAIG
BRUCE
DENHOLM
Title or Position: PRESIDENT/OWNER
Credential: DC
Phone: 989-348-6600