Healthcare Provider Details

I. General information

NPI: 1992203558
Provider Name (Legal Business Name): CARLS CHIROPRACTIC HEALTH CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2018
Last Update Date: 01/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

952 VASSAR DR
KALAMAZOO MI
49001-4436
US

IV. Provider business mailing address

952 VASSAR DR
KALAMAZOO MI
49001-4436
US

V. Phone/Fax

Practice location:
  • Phone: 269-344-7946
  • Fax: 269-344-6196
Mailing address:
  • Phone: 269-344-7946
  • Fax: 269-344-6196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberJC002732
License Number StateMI

VIII. Authorized Official

Name: DR. JOHN C CARLS
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 269-344-7946