Healthcare Provider Details

I. General information

NPI: 1114031168
Provider Name (Legal Business Name): DARL DEVON ALBRECHT DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 DIX STREET
OTSEGO MI
49078
US

IV. Provider business mailing address

304 DIX STREET
OTSEGO MI
49078
US

V. Phone/Fax

Practice location:
  • Phone: 269-694-9956
  • Fax: 269-694-9400
Mailing address:
  • Phone: 269-694-9956
  • Fax: 269-694-9400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number005124
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: