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General NPI Number Information
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NPI Number | 1285875013
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Entity Type | Organization
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Legal Business Name | PROMED HEALTHCARE
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Dates
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Enumeration Date | 03/06/2009
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Last Update Date | 03/06/2009
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Provider Practice Location Address
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Address Line | 3025 GULL RD
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City | KALAMAZOO
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State | MI
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Zip | 49048-1281
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Country | US
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Telephone | 269-552-2225
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Fax |
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Provider Business Mailing Address
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Address Line | 5943 STADIUM DR SUITE 1
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City | KALAMAZOO
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State | MI
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Zip | 49009-3016
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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 | CMO/COO
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Name | EDWARD M MILLERMAIER
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Credential | MD
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Telephone | 269-552-2910
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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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