Healthcare Provider Details

I. General information

NPI: 1023268422
Provider Name (Legal Business Name): ONSTOTT CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 02/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 E WRIGHT AVE
SHEPHERD MI
48883-8018
US

IV. Provider business mailing address

175 E WRIGHT AVE
SHEPHERD MI
48883-8018
US

V. Phone/Fax

Practice location:
  • Phone: 989-828-5252
  • Fax: 989-828-4321
Mailing address:
  • Phone: 989-828-5252
  • Fax: 989-828-4321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCO009303
License Number StateMI

VIII. Authorized Official

Name: CRAIG GERALD ONSTOTT
Title or Position: OWNER
Credential: DC
Phone: 989-828-5252