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General NPI Number Information
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NPI Number | 1245860915
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Entity Type | Organization
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Legal Business Name | CRYSTAL CARE CHIROPRACTIC
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Dates
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Enumeration Date | 01/22/2020
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Last Update Date | 01/22/2020
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Provider Practice Location Address
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Address Line | 1951 BENZIE HWY
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City | BENZONIA
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State | MI
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Zip | 49616-9691
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Country | US
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Telephone | 231-871-1817
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Fax |
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Provider Business Mailing Address
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Address Line | 1951 BENZIE HWY
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City | BENZONIA
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State | MI
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Zip | 49616-9691
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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 | SOLE MBR
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Name | DR. BRITTA CICANSKY CECH
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Credential | DC
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Telephone | 231-871-1817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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