Organization
SPARTAN FAMILY CHIROPRACTIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN T PARKER DC (OWNER/PHYSICAN)
(517) 381-9730
Entity
Organization
Contact information
Practice address
1719 W GRAND RIVER AVE, OKEMOS, MI 48864-1803
(517) 381-9730
(517) 381-9735
Mailing address
1719 W GRAND RIVER AVE, OKEMOS, MI 48864-1803
(517) 381-9730
(517) 381-9735
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
2301008073
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C35089
BCBS PROVIDER #
MI
01
—
4400103
PHP PROVIDER ID#
—
01
—
7703223
AETNA PROVIDER #
MI
Enumeration date
04/07/2006
Last updated
05/09/2018
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