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General NPI Number Information
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NPI Number | 1760954697
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Entity Type | Organization
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Legal Business Name | BIG RAPIDS CHIROPRACTIC, PLC
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Dates
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Enumeration Date | 12/17/2018
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Last Update Date | 05/01/2019
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Provider Practice Location Address
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Address Line | 109 S WARREN AVE
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City | BIG RAPIDS
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State | MI
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Zip | 49307-1843
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Country | US
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Telephone | 231-796-0760
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Fax |
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Provider Business Mailing Address
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Address Line | 258 JAMES ST STE 10
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City | HOLLAND
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State | MI
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Zip | 49424-1806
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Country | US
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Telephone | 616-396-6635
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Fax |
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Authorized Official
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Title or Position | BILLING COORDINATOR
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Name | JESSICA MONETZA
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Credential |
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Telephone | 616-396-6635
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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 |
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License Number State |
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