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General NPI Number Information
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NPI Number | 1538803564
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Entity Type | Organization
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Legal Business Name | PURE MOTION CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 04/26/2022
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 109 S LINCOLN AVE
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City | NILES
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State | MI
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Zip | 49120-2917
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Country | US
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Telephone | 269-684-7822
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Fax | 269-684-7088
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Provider Business Mailing Address
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Address Line | 109 S LINCOLN AVE
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City | NILES
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State | MI
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Zip | 49120-2917
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Country | US
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Telephone | 269-684-7822
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Fax | 269-684-7088
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Authorized Official
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Title or Position | OWNER
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Name | DR. SAMANTHA GERARD
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Credential | DC
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Telephone | 269-268-0145
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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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