Healthcare Provider Details

I. General information

NPI: 1043764558
Provider Name (Legal Business Name): DAWSON FAMILY CHIROPRACTIC PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1170 W MICHIGAN AVE
MARSHALL MI
49068-8545
US

IV. Provider business mailing address

1170 W MICHIGAN AVE
MARSHALL MI
49068-8545
US

V. Phone/Fax

Practice location:
  • Phone: 269-781-7000
  • Fax: 269-781-2522
Mailing address:
  • Phone: 269-781-7000
  • Fax: 269-781-2522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: BRENT DAWSON
Title or Position: OWNER
Credential: DC
Phone: 269-781-7000