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General NPI Number Information
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NPI Number | 1699763417
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Entity Type | Organization
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Legal Business Name | ACORN CHIROPRACTIC FAMILY HEALTH CLINIC INC PC
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 06/10/2013
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Provider Practice Location Address
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Address Line | 110 W CENTER ST
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City | HASTINGS
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State | MI
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Zip | 49058-1881
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Country | US
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Telephone | 269-945-5441
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Fax | 269-945-8804
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Provider Business Mailing Address
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Address Line | 110 W CENTER ST
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City | HASTINGS
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State | MI
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Zip | 49058-1881
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Country | US
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Telephone | 269-945-5441
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Fax | 269-945-8804
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DIANE KAY RIDDLE
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Credential | D.C.
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Telephone | 269-945-5441
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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 | DR007605
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DR0007688
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License Number State | MI
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