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General NPI Number Information
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NPI Number | 1811196272
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Entity Type | Organization
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Legal Business Name | NEW BOSTON CHIROPRACTIC LIFE CENTER, CORPORATION
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 03/14/2012
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Provider Practice Location Address
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Address Line | 405 E CHICAGO BLVD
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City | TECUMSEH
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State | MI
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Zip | 49286-1513
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Country | US
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Telephone | 517-423-2639
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Fax | 517-423-0639
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Provider Business Mailing Address
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Address Line | 405 E CHICAGO BLVD
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City | TECUMSEH
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State | MI
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Zip | 49286-1513
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Country | US
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Telephone | 517-423-2639
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Fax | 517-423-0639
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC/ PRESIDENT
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Name | DR. GREGORY KIM MCFARLAND JR.
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Credential | D.C.
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Telephone | 517-423-2639
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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 | 2301008358
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License Number State | MI
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