Organization
OBSIDIAN CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES JUSTIN AUSTIN DC (OWNER)
(850) 218-0677
Entity
Organization
Contact information
Practice address
2504 ARDMORE ST SE STE 102, GRAND RAPIDS, MI 49506-4901
(850) 218-0677
Mailing address
319 LYON ST NE APT 1, GRAND RAPIDS, MI 49503-3381
(850) 218-0677
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
11/20/2019
Last updated
11/20/2019
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