Healthcare Provider Details

I. General information

NPI: 1922371632
Provider Name (Legal Business Name): LOWELL FAMILY CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2012
Last Update Date: 02/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2531 W MAIN ST
LOWELL MI
49331-8695
US

IV. Provider business mailing address

2531 W MAIN ST
LOWELL MI
49331-8695
US

V. Phone/Fax

Practice location:
  • Phone: 616-897-8284
  • Fax: 616-897-6810
Mailing address:
  • Phone: 616-897-8284
  • Fax: 616-897-6810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301009430
License Number StateMI

VIII. Authorized Official

Name: DR. JAMES JOSEPH CHICHESTER
Title or Position: OWNER / DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 616-293-0385