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General NPI Number Information
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NPI Number | 1851003529
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Entity Type | Organization
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Legal Business Name | UNBOUND HEALING MINISTRIES
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Dates
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Enumeration Date | 12/14/2022
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Last Update Date | 12/21/2022
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Provider Practice Location Address
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Address Line | 2 W 19TH ST
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City | HOLLAND
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State | MI
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Zip | 49423-4128
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Country | US
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Telephone | 616-528-0099
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Fax |
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Provider Business Mailing Address
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Address Line | 2 W 19TH ST
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City | HOLLAND
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State | MI
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Zip | 49423-4128
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Country | US
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Telephone | 616-528-0099
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Fax |
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Authorized Official
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Title or Position | FOUNDING MEMBER
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Name | DR. CLINT JASON NOISEAU
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Credential | DC
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Telephone | 616-528-0099
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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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