Individual
DR. CHARLES MICHAEL LIETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3584 FAIRLANES AVE SW, GRANDVILLE, MI 49418-1583
(616) 530-3333
(616) 530-8320
Mailing address
3584 FAIRLANES AVE SW, GRANDVILLE, MI 49418-1583
(616) 530-3333
(616) 530-8320
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
L761039
MI
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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