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General NPI Number Information
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NPI Number | 1942569397
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Entity Type | Organization
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Legal Business Name | LIFE'S JOURNEY FAMILY CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 05/04/2012
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Last Update Date | 05/04/2012
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Provider Practice Location Address
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Address Line | 25 JACKSON INDUSTRIAL DR SUITE 500
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City | ANN ARBOR
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State | MI
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Zip | 48103-9110
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Country | US
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Telephone | 734-673-7755
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Fax |
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Provider Business Mailing Address
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Address Line | 108 HAWTHORNE DR
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City | BROOKLYN
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State | MI
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Zip | 49230-8924
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KATHERINE MILLER
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Credential | D.C.
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Telephone | 734-673-7755
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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 | 2301009904
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License Number State | MI
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