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General NPI Number Information
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NPI Number | 1295985851
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Entity Type | Organization
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Legal Business Name | CLEAR CHOICE CHIROPRACTIC OF NILES, P.C.
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Dates
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Enumeration Date | 09/19/2008
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Last Update Date | 09/19/2008
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Provider Practice Location Address
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Address Line | 60 E MAIN ST
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City | NILES
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State | MI
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Zip | 49120-2200
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Country | US
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Telephone | 269-683-6000
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Fax | 269-683-6350
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Provider Business Mailing Address
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Address Line | P.O. BOX 725
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City | NILES
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State | MI
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Zip | 49120-2200
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Country | US
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Telephone | 269-683-6000
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Fax | 269-683-6350
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Authorized Official
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Title or Position | CHAIRMAN
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Name | DR. TOBY ANDREW MITCHELL
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Credential | D.C.
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Telephone | 269-683-6000
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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 | 2301007476
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License Number State | MI
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