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General NPI Number Information
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NPI Number | 1194187567
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Entity Type | Organization
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Legal Business Name | OUILLETTE CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 03/24/2016
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Last Update Date | 12/03/2020
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Provider Practice Location Address
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Address Line | 8082 GRAND RIVER RD
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City | BRIGHTON
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State | MI
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Zip | 48114-9341
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Country | US
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Telephone | 810-295-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 8082 GRAND RIVER RD
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City | BRIGHTON
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State | MI
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Zip | 48114-9341
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Country | US
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Telephone | 810-295-2200
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. QUINN JOSEPH OUILLETTE
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Credential | D.C.
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Telephone | 989-324-9778
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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 | 2301010364
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License Number State | MI
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