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General NPI Number Information
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NPI Number | 1508892910
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Entity Type | Organization
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Legal Business Name | NORTHERN MICHIGAN CHIROPRACTIC CENTER, PLC
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 10/30/2014
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Provider Practice Location Address
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Address Line | 970 N CENTER AVE
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City | GAYLORD
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State | MI
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Zip | 49735-9375
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Country | US
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Telephone | 989-731-4050
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Fax | 989-731-4803
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Provider Business Mailing Address
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Address Line | 970 N CENTER AVE
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City | GAYLORD
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State | MI
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Zip | 49735-9375
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Country | US
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Telephone | 989-731-4050
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Fax | 989-731-4803
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN DOUGLAS OLIVER
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Credential | D.C.
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Telephone | 989-731-4050
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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 | MI
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