Healthcare Provider Details
I. General information
NPI: 1871904474
Provider Name (Legal Business Name): GARRETT JOHN-OTTO KUHLMAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/16/2014
Last Update Date: 02/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2810 CHARLEVOIX RD STE 101
PETOSKEY MI
49770-8421
US
IV. Provider business mailing address
2810 CHARLEVOIX RD STE 101
PETOSKEY MI
49770-8421
US
V. Phone/Fax
- Phone: 231-881-9280
- Fax: 231-881-9288
- Phone: 231-881-9280
- Fax: 231-881-9288
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 230101078 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: