Healthcare Provider Details

I. General information

NPI: 1932288800
Provider Name (Legal Business Name): JANICE E GRACE D.C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 E MICHIGAN AVE
MARSHALL MI
49068-1667
US

IV. Provider business mailing address

968 GRAHAM LAKE TER
BATTLE CREEK MI
49014-8309
US

V. Phone/Fax

Practice location:
  • Phone: 269-781-7000
  • Fax:
Mailing address:
  • Phone: 269-979-4381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8137
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: