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General NPI Number Information
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NPI Number | 1588938583
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Entity Type | Organization
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Legal Business Name | AK CHIROPRACTIC RESEARCH CENTER PLLC
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Dates
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Enumeration Date | 03/08/2012
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Last Update Date | 05/08/2012
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Provider Practice Location Address
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Address Line | 115 CLOVER ST STE 100
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City | HOLLAND
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State | MI
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Zip | 49423-3266
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Country | US
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Telephone | 616-392-2166
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Fax |
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Provider Business Mailing Address
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Address Line | 115 CLOVER ST STE 100
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City | HOLLAND
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State | MI
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Zip | 49423-3266
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Country | US
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Telephone | 616-392-2166
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. LOUIS C BOVEN
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Credential | DC
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Telephone | 616-392-2166
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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 | L2103517
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License Number State | MI
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