MEDICARE: ADVANCED FAMILY CHIROPRACTIC CENTER PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2301007550	MI

General Provider Information

NPI Number	:	1235337361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED FAMILY CHIROPRACTIC CENTER PC

Provider Business Mailing Address
First Line	:	4310 LEONARD ST NW
Second Line	:	SUITE 103
City	:	WALKER
State	:	MI
Zip	:	49534-8447
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4310 LEONARD ST NW
Second Line	:	SUITE 103
City	:	WALKER
State	:	MI
Zip	:	49534-8447
Country	:	US
Telephone Number	:	616-453-0600
Fax Number	:

Authorized Official
Title or Position	:	PRESIDNET/OWNER
Name	:	DR. JOHN OWINGS
Credential	:	DC
Telephone Number	:	616-453-0600

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	07/10/2007

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