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General NPI Number Information
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NPI Number | 1952276529
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Entity Type | Organization
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Legal Business Name | CARDINAL NATUROPATHIC AND FUNCTIONAL WELLNESS LLC
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Dates
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Enumeration Date | 10/06/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 17204 VAN WAGONER RD
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City | SPRING LAKE
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State | MI
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Zip | 49456-9702
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Country | US
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Telephone | 616-844-8327
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Fax |
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Provider Business Mailing Address
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Address Line | 17657 168TH AVE
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City | SPRING LAKE
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State | MI
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Zip | 49456-1466
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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 | OWNER
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Name | ASHLEY ELIZABETH HOOLAHAN-RICE
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Credential |
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Telephone | 616-844-8327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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