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General NPI Number Information
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NPI Number | 1962907600
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Entity Type | Organization
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Legal Business Name | BEYOND THE SPINE CHIROPRACTIC & MASSAGE PLLC
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 03/26/2018
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Provider Practice Location Address
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Address Line | 418 BROADWAY ST
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City | SOUTH HAVEN
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State | MI
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Zip | 49090-1421
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Country | US
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Telephone | 269-588-0752
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Fax |
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Provider Business Mailing Address
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Address Line | 418 BROADWAY ST
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City | SOUTH HAVEN
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State | MI
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Zip | 49090-1421
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Country | US
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Telephone | 269-588-0752
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTIC PHYSICIAN
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Name | DR. CHRISTINE NICOLE TAYLOR
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Credential | DC
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Telephone | 269-588-0752
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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 | 2301010365
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License Number State | MI
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