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General NPI Number Information
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NPI Number | 1972060093
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Entity Type | Organization
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Legal Business Name | CONCORD CHIROPRACTIC LLC
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Dates
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Enumeration Date | 02/25/2019
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Last Update Date | 12/13/2019
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Provider Practice Location Address
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Address Line | 119 W JACKSON RD
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City | CONCORD
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State | MI
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Zip | 49237-9617
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Country | US
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Telephone | 517-524-2225
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Fax |
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Provider Business Mailing Address
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Address Line | 119 SPRING ARBOR RD
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City | CONCORD
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State | MI
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Zip | 49237-9617
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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 | DR. WHITNEY SMITH
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Credential | DC
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Telephone | 517-524-2225
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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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