Healthcare Provider Details

I. General information

NPI: 1811196272
Provider Name (Legal Business Name): NEW BOSTON CHIROPRACTIC LIFE CENTER, CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 03/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 E CHICAGO BLVD
TECUMSEH MI
49286-1513
US

IV. Provider business mailing address

405 E CHICAGO BLVD
TECUMSEH MI
49286-1513
US

V. Phone/Fax

Practice location:
  • Phone: 517-423-2639
  • Fax: 517-423-0639
Mailing address:
  • Phone: 517-423-2639
  • Fax: 517-423-0639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301008358
License Number StateMI

VIII. Authorized Official

Name: DR. GREGORY KIM MCFARLAND JR.
Title or Position: DOCTOR OF CHIROPRACTIC/ PRESIDENT
Credential: D.C.
Phone: 517-423-2639