Organization
SOUTHLAND CHIROPRACTIC CENTER, P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEOFFREY KEMOLI SAGALA D.C (PRESIDENT)
(313) 595-5668
Entity
Organization
Contact information
Practice address
13400 FORT ST, SOUTHGATE, MI 48195-1138
(313) 595-5668
Mailing address
13400 FORT ST, SOUTHGATE, MI 48195-1138
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
004948
MI
Other
Enumeration date
05/22/2015
Last updated
05/22/2015
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