Individual
ETHAN H CHILDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
229 N BRIDGE ST, GRAND LEDGE, MI 48837
(517) 627-7070
(517) 627-0976
Mailing address
229 N BRIDGE ST, GRAND LEDGE, MI 48837
(517) 627-7070
(517) 627-0976
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301008476
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1009988
MCLAREN
MI
05
—
4570468
—
MI
01
—
9508350410
BCBS
MI
Enumeration date
09/07/2006
Last updated
03/22/2011
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