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General NPI Number Information
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NPI Number | 1215090584
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Entity Type | Organization
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Legal Business Name | COPPER COUNTRY CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 903 RAZORBACK DR SUITE 2
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City | HOUGHTON
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State | MI
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Zip | 49931-2825
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Country | US
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Telephone | 906-483-2255
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Fax |
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Provider Business Mailing Address
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Address Line | 503 W EDWARDS AVE
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City | HOUGHTON
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State | MI
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Zip | 49931-2332
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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 | CHIROPRACTOR
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Name | DR. TED LOREN BIER
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Credential | D.C.
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Telephone | 906-483-2250
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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 | 2301009111
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License Number State | MI
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