Organization
FOUNTAIN OF LIFE CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN NICHOLAS FOUNTAIN D.C. (PRESIDENT/OWNER)
(906) 440-9272
Entity
Organization
Contact information
Practice address
267 CREEKSIDE DR, SUITE 100, PETOSKEY, MI 49770-7609
(231) 347-1776
(231) 347-1778
Mailing address
267 CREEKSIDE DR, SUITE 100, PETOSKEY, MI 49770-7609
(231) 347-1776
(231) 347-1778
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
05/15/2013
Last updated
05/15/2013
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