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Organization

DE BOARD CHIROPRACTIC P C

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TIMOTHY D DEBOARD D C (OWNER)
(269) 651-9448
Entity
Organization

Contact information

Practice address
204 E WEST ST, STURGIS, MI 49091-1444
(269) 651-9448
(269) 659-3228
Mailing address
204 E WEST ST, STURGIS, MI 49091-1444
(269) 651-9448
(269) 659-3228

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301007577
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0M66050
MEDICARE ID
MI
01
44-30215
PHP
MI
01
950G510810
BCBS ID
MI
Enumeration date
08/18/2008
Last updated
08/27/2008
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