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General NPI Number Information
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NPI Number | 1053982959
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Entity Type | Organization
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Legal Business Name | CORE PERFORMANCE CHIROPRACTIC P.L.L.C.
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Dates
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Enumeration Date | 07/02/2021
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Last Update Date | 07/02/2021
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Provider Practice Location Address
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Address Line | 401 MCMORRAN BLVD
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City | PORT HURON
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State | MI
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Zip | 48060-3809
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Country | US
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Telephone | 810-987-4740
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Fax |
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Provider Business Mailing Address
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Address Line | 1434 NEW HAMPSHIRE AVE
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City | MARYSVILLE
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State | MI
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Zip | 48040-1707
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Country | US
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Telephone | 810-357-7735
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. ANDREW CAMERON ST. COEUR
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Credential | D.C.
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Telephone | 810-357-7735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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