Organization
WATERS EDGE CHIROPRACTIC PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK DEAN JOHNSON D.C. (CEO)
(906) 399-2800
Entity
Organization
Contact information
Practice address
922 DELTA AVE, GLADSTONE, MI 49837-1649
(906) 428-9076
Mailing address
1010 DELTA AVE STE 216, GLADSTONE, MI 49837-1522
(906) 428-9076
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
2301009453
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1200009
—
MI
Enumeration date
03/17/2008
Last updated
03/17/2021
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