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Organization

OTISVILLE CHIROPRACTIC CENTER PC

Active
Parent organization
OTISVILLE CHIROPRACTIC CENTER PC
Organization subpart
Yes

Provider details

NPI number
Legal business name
OTISVILLE CHIROPRACTIC CENTER PC
Authorized official
DR. VIRGIL BROWN LOVE D.C. (DOCTOR)
(810) 767-6221
Entity
Organization

Contact information

Practice address
3413 CORUNNA RD, FLINT, MI 48503-3265
(810) 767-6221
(810) 767-4429
Mailing address
3413 CORUNNA RD, FLINT, MI 48503-3265
(810) 767-6221
(810) 767-4429

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
23010002905
MI
111N00000X
Chiropractor
231002905
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
231002905
STATE LICENSE NUMBER
MI
01
950B512120
BLUE CROSS
MI
Enumeration date
06/25/2007
Last updated
11/11/2009
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