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General NPI Number Information
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NPI Number | 1114663176
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Entity Type | Organization
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Legal Business Name | 100 CHIRO SANTOS BARKER PC
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Dates
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Enumeration Date | 05/11/2022
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Last Update Date | 05/11/2022
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Provider Practice Location Address
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Address Line | 1833 MARKETPLACE DR SE
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City | CALEDONIA
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State | MI
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Zip | 49316-8506
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Country | US
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Telephone | 719-217-0895
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Fax |
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Provider Business Mailing Address
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Address Line | 1833 MARKETPLACE DR SE
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City | CALEDONIA
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State | MI
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Zip | 49316-8506
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANGEL SANTOS
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Credential |
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Telephone | 616-206-4294
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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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