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General NPI Number Information
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NPI Number | 1093681611
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Entity Type | Organization
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Legal Business Name | BOREALIS COMPLEMENTARY CARE CENTER INC
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Dates
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Enumeration Date | 10/13/2025
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 2301 E MICHIGAN AVE STE 101I
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City | JACKSON
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State | MI
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Zip | 49202-3765
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Country | US
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Telephone | 517-416-6669
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 464
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City | GRASS LAKE
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State | MI
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Zip | 49240-0464
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Country | US
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Telephone | 517-416-6669
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Fax |
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Authorized Official
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Title or Position | DC
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Name | DAWN GEIGER
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Credential |
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Telephone | 517-416-6669
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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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