Healthcare Provider Details

I. General information

NPI: 1659578987
Provider Name (Legal Business Name): WALTON CHIROPRACTIC CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 09/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W CARLETON RD
HILLSDALE MI
49242-1354
US

IV. Provider business mailing address

401 W CARLETON RD PO BOX 401
HILLSDALE MI
49242-1354
US

V. Phone/Fax

Practice location:
  • Phone: 517-437-0900
  • Fax:
Mailing address:
  • Phone: 517-437-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberKW007298
License Number StateMI

VIII. Authorized Official

Name: DR. KEVIN MICHAEL WALTON
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 517-437-0900