Individual
DR. ERNEST RICHARD CENTOFANTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C., C.C.S.P.
Contact information
Practice address
3078 MAIN ST, MARLETTE, MI 48453-0245
(989) 635-3828
(989) 635-3828
Mailing address
3078 MAIN ST, PO BOX 245, MARLETTE, MI 48453-1292
(989) 635-3828
(989) 635-3828
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
005491
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2582862
—
MI
01
—
950G65244
BLUE CROSS
MI
Enumeration date
07/02/2006
Last updated
07/08/2007
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