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General NPI Number Information
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NPI Number | 1871884940
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Entity Type | Organization
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Legal Business Name | DUNHAM CHIROPRACTIC P.C.
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Dates
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Enumeration Date | 04/25/2011
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Last Update Date | 05/16/2011
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Provider Practice Location Address
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Address Line | 2120 GRAND RIVER ANX STE 100
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City | BRIGHTON
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State | MI
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Zip | 48114-7390
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Country | US
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Telephone | 810-225-7191
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Fax | 810-225-7192
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Provider Business Mailing Address
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Address Line | 2120 GRAND RIVER ANX STE 100
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City | BRIGHTON
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State | MI
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Zip | 48114-7390
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Country | US
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Telephone | 810-225-7191
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Fax | 810-225-7192
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. NATHAN JEREMY DUNHAM
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Credential | D.C.
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Telephone | 810-225-7191
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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 | ND009811
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License Number State | MI
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