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General NPI Number Information
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NPI Number | 1710149844
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Entity Type | Organization
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Legal Business Name | VILLAGE CHIROPRACTIC WELLNESS CENTER, PLC
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 798 W MILE RD NW
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City | KALKASKA
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State | MI
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Zip | 49646-8431
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Country | US
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Telephone | 231-258-4023
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Fax | 231-258-3291
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Provider Business Mailing Address
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Address Line | 798 W MILE RD NW
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City | KALKASKA
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State | MI
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Zip | 49646-8431
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Country | US
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Telephone | 231-258-4023
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Fax | 231-258-3291
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Authorized Official
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Title or Position | MEMBER
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Name | DR. KAREEN LEE OOSTERHART
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Credential | D.C.
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Telephone | 231-258-4023
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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 | 2301007436
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License Number State | MI
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