Healthcare Provider Details

I. General information

NPI: 1548213507
Provider Name (Legal Business Name): HOMETOWN CHIROPRACTIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 09/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 E HURON AVE
VASSAR MI
48768-1312
US

IV. Provider business mailing address

PO BOX 205
VASSAR MI
48768-0205
US

V. Phone/Fax

Practice location:
  • Phone: 989-823-7729
  • Fax: 989-823-1024
Mailing address:
  • Phone: 989-823-7729
  • Fax: 898-231-0249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301009029
License Number StateMI

VIII. Authorized Official

Name: DR. ERIC R. G. TRATO
Title or Position: PRESIDENT/CHIROPRACTOR
Credential: D.C.
Phone: 989-737-8620