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Organization

FOUNTAIN CHIRO LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GREG ROSS FOUNTAIN (OWNER)
(734) 652-7259
Entity
Organization

Contact information

Practice address
24640 TELEGRAPH RD, FLAT ROCK, MI 48134-9226
(734) 782-0200
(734) 782-0200
Mailing address
24640 TELEGRAPH RD, FLAT ROCK, MI 48134-9226
(734) 782-0200
(734) 782-0200

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301009847
MI

Other

Enumeration date
10/11/2016
Last updated
10/19/2016
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