Organization
NORTHWEST CHIROPRACTIC AND SPORTS MEDICINE PLLC
Active
Other names
Northwest Chiropractic and Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES RYAN DIETRICK DC (OWNER)
(231) 629-8833
Entity
Organization
Contact information
Practice address
14321 NORTHLAND DR STE 1, BIG RAPIDS, MI 49307-2310
(231) 629-8833
(231) 629-8834
Mailing address
2849 S BALDWIN AVE, FREMONT, MI 49412-7816
(616) 916-6753
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
2301010554
MI
Other
Enumeration date
08/16/2017
Last updated
07/09/2019
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