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General NPI Number Information
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NPI Number | 1831233931
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Entity Type | Organization
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Legal Business Name | THUNDER BAY CHIROPRACTIC CENTER PC
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2477 US HIGHWAY 23 S STE C
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City | ALPENA
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State | MI
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Zip | 49707-4610
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Country | US
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Telephone | 989-356-4126
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Fax | 989-354-8715
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Provider Business Mailing Address
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Address Line | 2568 US HIGHWAY 23 S
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City | ALPENA
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State | MI
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Zip | 49707-4618
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Country | US
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Telephone | 989-356-4126
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Fax | 989-356-6331
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD EMIL CHURA
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Credential | D.C.
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Telephone | 989-356-4126
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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 | H
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License Number State | MI
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