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General NPI Number Information
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NPI Number | 1285819169
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Entity Type | Organization
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Legal Business Name | ST. JOHNS CHIROPRACTIC CLINIC, INC.
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 1004 N US HIGHWAY 27
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City | SAINT JOHNS
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State | MI
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Zip | 48879-1129
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Country | US
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Telephone | 989-224-8228
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Fax |
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Provider Business Mailing Address
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Address Line | 1004 N US HIGHWAY 27
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City | SAINT JOHNS
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State | MI
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Zip | 48879-1129
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Country | US
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Telephone | 989-224-8228
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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. RODGER W MASSA
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Credential |
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Telephone | 989-224-8228
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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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