Healthcare Provider Details

I. General information

NPI: 1164627709
Provider Name (Legal Business Name): ONAWAY CHIROPRACTIC CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20417 E STATE ST
ONAWAY MI
49765
US

IV. Provider business mailing address

PO BOX 74 20417 E STATE ST
ONAWAY MI
49765
US

V. Phone/Fax

Practice location:
  • Phone: 989-733-2800
  • Fax: 989-733-7571
Mailing address:
  • Phone: 989-733-2800
  • Fax: 989-733-7571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301005890
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301005624
License Number StateMI

VIII. Authorized Official

Name: DR. DOUGLAS A OLREE
Title or Position: PRES DC
Credential: DC
Phone: 989-733-2800