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General NPI Number Information
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NPI Number | 1689984049
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Entity Type | Organization
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Legal Business Name | VAN SKYHOCK CHIROPRACTIC HEALTH CENTER LLC
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Dates
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Enumeration Date | 10/19/2010
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Last Update Date | 02/16/2016
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Provider Practice Location Address
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Address Line | 111 E EDWARD ST
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City | MESICK
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State | MI
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Zip | 49668-9575
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Country | US
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Telephone | 231-885-3220
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Fax | 231-326-2112
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Provider Business Mailing Address
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Address Line | PO BOX 94
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City | EMPIRE
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State | MI
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Zip | 49630-0094
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Country | US
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Telephone | 231-885-3220
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Fax | 231-326-2112
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Authorized Official
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Title or Position | SOLE MBR
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Name | DR. JASON A VAN SKYHOCK
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Credential | DC
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Telephone | 231-885-3220
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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 | 2301009714
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License Number State | MI
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