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General NPI Number Information
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NPI Number | 1558559740
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Entity Type | Organization
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Legal Business Name | GENTLE TOUCH CHIROPRACTIC PC
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Dates
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Enumeration Date | 10/12/2007
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Last Update Date | 06/22/2022
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Provider Practice Location Address
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Address Line | 28051 DEQUINDRE RD STE F
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City | MADISON HTS
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State | MI
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Zip | 48071-3016
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Country | US
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Telephone | 248-733-5442
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Fax | 248-963-6214
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Provider Business Mailing Address
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Address Line | 28051 DEQUINDRE RD STE F
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City | MADISON HTS
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State | MI
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Zip | 48071-3016
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Country | US
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Telephone | 248-733-5442
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Fax | 248-963-6214
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. KEITH BOWEN GOVER
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Credential | DC
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Telephone | 248-667-6525
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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 | KG006620
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License Number State | MI
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