Organization
GREAT LAKES FAMILY CHIROPRACTIC PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCY LEE MAXWELL (OFFICE MANAGER)
(269) 668-3709
Entity
Organization
Contact information
Practice address
25344 RED ARROW HWY, STE A, MATTAWAN, MI 49071-9767
(269) 668-3709
(269) 668-3713
Mailing address
25344 RED ARROW HWY, STE A, MATTAWAN, MI 49071-9767
(269) 668-3709
(269) 668-3713
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4736930
—
MI
Enumeration date
12/04/2008
Last updated
12/05/2008
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