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General NPI Number Information
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NPI Number | 1992236061
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Entity Type | Organization
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Legal Business Name | RYCKMAN CHIROPRACTIC CLINIC PC
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 5154 MILLER RD STE J
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City | FLINT
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State | MI
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Zip | 48507-1065
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Country | US
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Telephone | 810-710-0310
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Fax |
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Provider Business Mailing Address
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Address Line | 5154 MILLER RD STE J
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City | FLINT
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State | MI
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Zip | 48507-1065
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Country | US
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Telephone | 810-710-0310
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. ADAM MACDONALD
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Credential | D.C.
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Telephone | 248-770-4930
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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 | 2301010514
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License Number State | MI
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