Organization
BREATH OF LIFE CHIROPRACTIC WELLNESS CENTER P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE MARTIN DENHOLM D.C. (OWNER)
(989) 619-4709
Entity
Organization
Contact information
Practice address
322 BAY ST, #3, PETOSKEY, MI 49770-2489
(231) 622-8828
(231) 622-8829
Mailing address
322 BAY ST, #3, PETOSKEY, MI 49770-2489
(231) 622-8828
(231) 622-8829
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301009264
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5195192
—
MI
01
—
950B01090
BCBS OF MICHIGAN
MI
Enumeration date
05/13/2009
Last updated
05/13/2009
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