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General NPI Number Information
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NPI Number | 1831407576
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Entity Type | Organization
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Legal Business Name | LANJOPOULOS CHIROPRACTIC
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Dates
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Enumeration Date | 09/15/2010
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Last Update Date | 09/15/2010
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Provider Practice Location Address
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Address Line | 309 E SAGINAW HWY
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City | GRAND LEDGE
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State | MI
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Zip | 48837-2191
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Country | US
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Telephone | 517-627-4547
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 44
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City | GRAND LEDGE
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State | MI
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Zip | 48837-0044
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Country | US
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Telephone | 517-627-4547
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DR. CHARMAINE LANJOPOULOS
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Credential | DC
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Telephone | 517-627-4547
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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 | 2301006722
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License Number State | MI
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